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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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist | |
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI # | 1013939768 |
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| LBN Legal business name | CVS STATE CAPITAL LLC | ||||||||
| Authorized official | SUSAN COLBERT - (SR. DIRECTOR, PAYER RELATIONS) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 07/24/2006 | ||||||||
| Last updated | 10/31/2016 - About 10 years ago | ||||||||
| Identifiers |
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CVS STATE CAPITAL LLC
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CVS STATE CAPITAL LLC