Provider Demographics
NPI:1053785964
Name:CVS PHARMACY
Entity type:Organization
Organization Name:CVS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LOUY
Authorized Official - Middle Name:
Authorized Official - Last Name:AL ATTEELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-800-3336
Mailing Address - Street 1:7107 W CINNABAR AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-6812
Mailing Address - Country:US
Mailing Address - Phone:602-800-3336
Mailing Address - Fax:
Practice Address - Street 1:28635 N NORTH VALLY PARKWAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085
Practice Address - Country:US
Practice Address - Phone:623-582-9207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021151333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy