# OHIO CVS STORES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS PHARMACY \#05457
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063516896
- **Authorized official:** SUSAN COLBERT (DIRECTOR, MANAGED CARE ADMIN)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 3488 SELDOM SEEN RD, POWELL, OH 43065-8405
- **Practice address phone:** (614) 718-1508
- **Mailing address:** 1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | — | — |
| 333600000X | Pharmacy | 02-1404150 | OH | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 09/12/2006
- **Last updated:** 12/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3671965 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |