National Provider Identifier Database

WISCONSIN CVS PHARMACY LLC
Pharmacy

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.


Contact Information

WISCONSIN CVS PHARMACY LLC
2149 PRAIRIE AVE.
BELOIT, WI53511
Phone: 608-362-1767
Fax:
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X

* Indicates primary specialty

NPI Profile & details for WISCONSIN CVS PHARMACY LLC

NPI Number 1114172400
Legal business name
LBN
WISCONSIN CVS PHARMACY LLC
Authorized official SUSAN COLBERT - (DIRECTOR PAYER RELATIONS)
Entity Organization
Organization subpart No
Enumeration date 12/01/2008
Last updated 03/07/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • WI Medicaid: 1114172400
  • Other: 5131280 NCPDP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for WISCONSIN CVS PHARMACY LLC

There are currently no reviews for WISCONSIN CVS PHARMACY LLC


NPIdb - Home
v2.201