Organization
VIRGINIA CVS PHARMACY 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
2511 ANDERSON HIGHWAY, POWHATAN, VA 23139-7508
(804) 598-5028
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENT, 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
—
1184075962
—
VA
01
—
4847402
NCPDP
VA
Enumeration date
06/23/2016
Last updated
02/23/2018
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