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Organization
WEST VIRGINIA CVS PHARMACY LLC
Active
Organization
WEST VIRGINIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY 01427
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIR PHCY ENROLLMENTS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
45 S MINERAL ST, KEYSER, WV 26726-3126
(304) 788-9774
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
MP0552296
WV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008099
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
08/27/2014
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