WASHINGTON CVS PHARMACY LLC NPI 1417030040

NPI Information

  • NPI: 1417030040
  • Provider Name: WASHINGTON CVS PHARMACY LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: CVS PHARMACY #17272
  • Address: 16818 TWIN LAKES AVE
    MARYSVILLE, WA
    ZIP 98271
  • Phone: (360) 386-4021

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NPI Details

WASHINGTON CVS PHARMACY LLC is a pharmacy in Marysville, WA. 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. WASHINGTON CVS PHARMACY LLC NPI is 1417030040. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #17272.

The provider's business location address is:

16818 TWIN LAKES AVE
MARYSVILLE, WA
ZIP 98271-724
Phone: (360) 386-4021
Fax: (360) 386-4021

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 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)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 10/24/2006 and was last updated on 11/28/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyPHAR.CF.60617626WASHINGTONNo
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17226960019MEDICARE NSC
22109012OTHERPK

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: 3/30/2025

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