Organization
VIRGINIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 02169
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
10901 W BROAD ST, GLEN ALLEN, VA 23060-5935
(804) 935-6916
Mailing address
1 CVS DR, PO 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
0201003552
VA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4833186
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
P00754820
MEDICARE RR
—
Enumeration date
09/20/2006
Last updated
07/17/2014
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