Nevada Cvs Pharmacy LLC
Pharmacy in Las Vegas, NV. Organization (NPI-2).
NPI number1104867076
StatusActive
Last updated in NPPESJun 3, 2019
Details
- NPI
- 1104867076
- Entity type
- Organization (NPI-2)
- Legal business name
- Nevada Cvs Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- Jun 9, 2006
- Last updated
- Jun 3, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · DME SUPPLIER - PHARMACY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | – | – | Yes |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Cvs Pharmacy # 08800 (Doing Business As)
Practice location
6705 E Lake Mead BlvdLas Vegas, NV 89156-1101
Phone 702-547-0220
Mailing address
1 Cvs DrPo Box 1075
Woonsocket, RI 02895-6146
Authorized official
Susan Colbert
Director, Payer Relations
4017651500
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