CVS Pharmacy #17404 – Pharmacy, NPI 1841448743

CVS Pharmacy #17404 is a healthcare provider. based in Wasilla, Alaska. specializing in Pharmacy. The organization holds a License No. 107509 (AK). The NPI Number for CVS Pharmacy #17404 is 1841448743

Main info

Organization
Name
CVS Pharmacy #17404
NPI
1841448743
Phone
(907) 373-9510
Address
1801 E PARKS HWY
Authorized Official
SUSAN COLBERT SR. DIRECTOR, PAYER RELATIONS
Enumeration Date
4 September 2008
Last Update Date
27 March 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness80
Years active:17State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for CVS Pharmacy #17404

  • 1801, East Parks Highway, Wasilla, Matanuska-Susitna, Alaska, 99654, United States

    WASILLA, AK 996547350

    Phone: (907) 373-9510

    Fax: (907) 631-7201

    Type: Location

  • CVS Caremark Corporation, 1, CVS Drive, Woonsocket, Providence County, Rhode Island, 02895, United States

    BOX 1075

    WOONSOCKET, RI 028956146

    Phone: (401) 765-1500

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-09-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-06-30 (347 days ago).

Enrollment records

1

Earliest due date

2025-06-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20160830000488OPharmacyAK2025-06-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine146143$0
90480Admn sarscov2 vacc 1 dose108108$0
91320Sarscv2 vac 30mcg trs-suc im108108$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage106105$0
90662Influenza vaccine split virus, preservative free3030$0
View full utilization report →

Insurance plans in this area (ZIP 99654)

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Reviews

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Frequently asked questions

How do payers reference CVS Pharmacy #17404?
For CVS Pharmacy #17404, use NPI 1841448743 as the unique 10-digit identifier.
Is CVS Pharmacy #17404 still an active registrant?
CVS Pharmacy #17404 carries an active NPI according to the public dataset.
What expertise is attributed to CVS Pharmacy #17404?
CVS Pharmacy #17404's specialty line reads Pharmacy. Clinical services aligned with this taxonomy classification.
What practice footprint exists for CVS Pharmacy #17404?
Travel planning: use Wasilla, Alaska as the reference point for CVS Pharmacy #17404, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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