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Organization

OHIO CVS STORES LLC

Active
Other names
CVS Pharmacy # 00396
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization

Contact information

Practice address
200 BROADWAY E, GRANVILLE, OH 43023-1306
(740) 587-0268
(401) 770-7108
Mailing address
ONE CVS DRIVE, BOX 1075-PHARMACY ENROLLMENTS, WOONSOCKET, ID 02895
(401) 765-1500
(401) 770-7108

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
021632650
OH
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3675014
NCPDP
Enumeration date
10/18/2006
Last updated
12/02/2010
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