Pennsylvania Cvs Pharmacy, LLC
NPI 1790105104 · Pharmacy · Philadelphia, PA
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pennsylvania Cvs Pharmacy, LLC is a Pharmacy organization in Philadelphia, PA (NPI 1790105104).
Provider details
- NPI number
- 1790105104
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Susan Colbert, Director, Payer Relations(401) 765-1500
Specialties & taxonomies
Suppliers
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
12 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
618 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of Influenza Virus VaccineG0008 | 325 | $30 |
| Admn Sarscov2 Vacc 1 Dose90480 | 264 | $38 |
| Administration of Pneumococcal VaccineG0009 | 29 | $30 |
Typical Medicare-allowed amounts for these services range $30–$38 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Cvs Pharmacy # 02170
Registry dates
- Enumerated
- 2014-04-24
- Last updated
- 2015-03-11
Frequently asked questions
- What is Pennsylvania Cvs Pharmacy, LLC's NPI number?
- Pennsylvania Cvs Pharmacy, LLC's National Provider Identifier (NPI) is 1790105104, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pennsylvania Cvs Pharmacy, LLC?
- Pennsylvania Cvs Pharmacy, LLC is classified in the NPPES registry as Pharmacy (Suppliers).
- Where is Pennsylvania Cvs Pharmacy, LLC located?
- Pennsylvania Cvs Pharmacy, LLC's practice location on file with NPPES is 3331 Grant Ave, Philadelphia, PA 19114-2629.
- What is Pennsylvania Cvs Pharmacy, LLC's phone number?
- The practice phone number listed in the NPPES registry for Pennsylvania Cvs Pharmacy, LLC is (215) 464-2636.
- Does Pennsylvania Cvs Pharmacy, LLC accept Medicare?
- Pennsylvania Cvs Pharmacy, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Pennsylvania Cvs Pharmacy, LLC?
- The authorized official listed on Pennsylvania Cvs Pharmacy, LLC's NPPES record is Susan Colbert, Director, Payer Relations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pennsylvania Cvs Pharmacy, LLC's NPI active?
- Yes — Pennsylvania Cvs Pharmacy, LLC's NPI (1790105104) is active in the NPPES registry as of the last update on 2015-03-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.