Organization
OHIO CVS STORES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
210 E EMMITT AVE, WAVERLY, OH 45690-1336
(740) 947-2126
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0191461
—
OH
01
—
3684582
NCPDP
OH
Enumeration date
09/09/2016
Last updated
12/05/2017
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