Organization
WEST VIRGINIA CVS PHARMACY LLC
Active
Other names
TARGET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1329 TARGET WAY, MORGANTOWN, WV 26501-2267
(304) 599-5581
(304) 599-5581
Mailing address
1 CVS DR, MAIL CODE 1090, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
MP0552318
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007283250092
—
PA
01
—
2111512
PK
—
05
—
6001374000
—
WV
Enumeration date
07/26/2006
Last updated
11/12/2020
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