Organization
OHIO CVS STORES LLC
Active
Other names
CVS PHARMACY #05458
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2565 LONDON GROVEPORT RD, GROVE CITY, OH 43123-9035
(614) 277-2921
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
02-1382850
OH
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200893260A
—
IN
05
—
2416817
—
OH
01
—
3671547
NCPDP
OH
Enumeration date
09/12/2006
Last updated
10/25/2011
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