PENNSYLVANIA CVS PHARMACY L.L.C. NPI 1750482212

NPI Information

  • NPI: 1750482212
  • Provider Name: PENNSYLVANIA CVS PHARMACY, L.L.C.
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: CVS PHARMACY #01320
  • Address: RT 115 AND 209 HC2
    BOX 1120
    BROADHEADSVILLE, PA
    ZIP 18322
  • Phone: (717) 992-6454

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NPI Details

PENNSYLVANIA CVS PHARMACY, L.L.C. is a pharmacy in Broadheadsville, PA. 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. PENNSYLVANIA CVS PHARMACY, L.L.C. NPI is 1750482212. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #01320.

The provider's business location address is:

RT 115 AND 209 HC2
BOX 1120
BROADHEADSVILLE, PA
ZIP 18322
Phone: (717) 992-6454

The provider's authorized official is Susan Colbert .
The authorized official title is 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)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)

The enumeration date for this NPI number is 9/26/2006 and was last updated on 3/8/2012.

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
3333600000XPharmacyPP414193LPENNSYLVANIAYes

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
15619370254MEDICARE NSC
2120568MEDICARE PIN
33961441OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
4P00979144MEDICARE PINPENNSYLVANIA

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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