Organization
VIRGINIA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 01733
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F. COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6360 HOADLY RD, MANASSAS, VA 20112
(703) 897-4961
(401) 770-7108
Mailing address
1 CVS DR, BOX 1075- PHARMACY ENROLLMENTS, 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
—
1245429935
—
VA
01
—
4840573
NCPDP
VA
Enumeration date
10/18/2007
Last updated
07/17/2014
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