# OHIO CVS STORES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS PHARMACY 03416
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639272362
- **Authorized official:** SUSAN COLBERT (DIRECTOR)
- **Authorized official phone:** (401) 765-1500

## Contact information

- **Practice address:** 802 11TH ST, PORTSMOUTH, OH 45662-3409
- **Practice address phone:** (614) 354-3259
- **Mailing address:** 1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | 21-03400 | OH | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 06/09/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3615626 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |