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Organization
OHIO CVS STORES LLC
Active
Organization
OHIO CVS STORES LLC
Active
Other names
CVS PHARMACY #03474
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (EXEC DIR, RX SERVICES)
(401) 770-2751
Entity
Organization
Contact information
Practice address
320 JEFFERSON ST, IRONTON, OH 45638-1859
(740) 532-4354
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
Primary
2161700
OH
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0403058
—
OH
01
—
3635147
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3810016575
—
WV
05
—
710003990000
—
KY
Enumeration date
09/07/2006
Last updated
01/12/2023
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