Cvs Pharmacy # 10400

LBN: Mississippi Cvs Pharmacy Llc
Cvs Pharmacy # 10400 is an health care organization with primary practice located at 1435 N. Frontage Rd , Vicksburg MS 39180-5170. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Mississippi Cvs Pharmacy Llc can be contacted via phone (601) 661-9652, or through Colbert, Susan F via phone (401) 765-1500.

Contact Information

Primary practice address
1435 N. Frontage Rd Vicksburg MS 39180-5170
Phone: (601) 661-9652
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Colbert, Susan F
Phone: (401) 765-1500

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1740682210
LBN Legal business name Mississippi Cvs Pharmacy Llc
DBA Doing business as Cvs Pharmacy # 10400
Authorized official Colbert, Susan F
Entity Organization
Organization subpart 1 No
Enumeration date Sep 16th, 2014
Last updated Apr 6th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740682210 NPPES
Mississippi Other 2589907 NCPDP
Mississippi MEDICAID 09752075 RX NCPDP

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