CMS-1500 Box 24J / 33a • NPI
1649409145
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
333600000X (CMS 58)
Licensed & Credentialed Suppliers — Pharmacy
Box 32 Service Location & ZIP+4
3501 STOCKTON HILL RD, KINGMAN, AZ, 86409
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1649409145 (ARIZONA CVS STORES, L.L.C.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1649409145)
Medicare Beneficiaries
473
Total Billed Services
1,558
Distinct CPT/HCPCS Codes
12
Medicare Allowed Total
$120,087.94
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
90480 | Admn sarscov2 vacc 1 dose | 288 |
90653 | Influenza vaccine, inactivated | 149 |
90662 | Influenza vaccine split virus, preservative free | 272 |
90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 52 |
91320 | Sarscv2 vac 30mcg trs-suc im | 286 |
G0008 | Administration of influenza virus vaccine | 435 |
G0009 | Administration of pneumococcal vaccine | 56 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1649409145 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ARIZONA CVS STORES, L.L.C. |
| Plain-English Specialty | Licensed & Credentialed Suppliers — Pharmacy NUCC Code: 333600000X (Pharmacy) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 3501 STOCKTON HILL RD, KINGMAN, AZ, 86409 |
| Practice Telephone / Fax | Tel: (928) 757-1999 |
| Administrative Mailing Address | 1 CVS DR, WOONSOCKET, RI, 02895-6146 |
| Enumeration & Last Sync | Enumerated: 2009-07-07 | CMS Record Updated: 2022-12-20 |
| Authorized Official | SUSAN COLBERT (DIRECTOR PAYER RELATIONS) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (333600000X)
What Does Taxonomy Code 333600000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 333600000X translates to:
"Licensed & Credentialed Suppliers — Pharmacy"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ARIZONA CVS STORES, L.L.C.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
332B00000X — Durable Medical Equipment & Medical SuppliesPlain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies | State: N/A | License: Verified | Primary: Secondary |
3336C0003X — Pharmacy, Community/Retail PharmacyPlain English: Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy | State: N/A | License: Verified | Primary: Secondary |
333600000X — PharmacyPlain English: Licensed & Credentialed Suppliers — Pharmacy | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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