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WOODWARD DETROIT CVS LLC NPI 1386686574


NPI Information

NPI: 1386686574
Provider Name: WOODWARD DETROIT CVS LLC

Doing Business As: CVS PHARMACY #17191

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 23D2219442

Address:
3255 OWEN RD
FENTON, MI
ZIP 48430
Phone: (810) 714-2406
Get Directions

WOODWARD DETROIT CVS LLC is a pharmacy in Fenton, MI. 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. WOODWARD DETROIT CVS LLC NPI is 1386686574. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #17191.

The provider's business location address is:

3255 OWEN RD
FENTON, MI
ZIP 48430-755
Phone: (810) 714-2406
Fax: (810) 354-9094

The provider's authorized official is Susan Colbert .
The authorized official title is Sr. Director, Payer Relations and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 23D2219442 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 9/28/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail Pharmacy5301010862MICHIGANNo
3333600000XPharmacyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15603870262MEDICARE NSC
22042312OTHERPK

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: 4/28/2024

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