NEW JERSEY CVS PHARMACY LLC NPI 1104929926

NPI Information

  • NPI: 1104929926
  • Provider Name: NEW JERSEY CVS PHARMACY LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: CVS PHARMACY #06032
  • CLIA Number: 31D2282250
  • Address: 3560 RTE 27
    KENDALL PARK, NJ
    ZIP 08824
  • Phone: (732) 422-4336

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NPI Details

NEW JERSEY CVS PHARMACY LLC is a pharmacy in Kendall Park, NJ. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. NEW JERSEY CVS PHARMACY LLC NPI is 1104929926. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #06032.

The provider's business location address is:

3560 RTE 27
KENDALL PARK, NJ
ZIP 08824
Phone: (732) 422-4336

The provider's authorized official is Susan Colbert .
The authorized official title is Dir.,managed Care Administration and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 31D2282250 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Pneumococcal vaccine, 23-valent (HCPCS:90732)

The enumeration date for this NPI number is 9/7/2006 and was last updated on 6/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy4454NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15867310235MEDICARE NSC
2185232MEDICARE PIN
3P00959557MEDICARE PIN
40235865MEDICAIDNEW JERSEY
53131771OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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