Organization
WEST VIRGINIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY 04432
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
300 4TH AVE, MONTGOMERY, WV 25136-2204
(304) 442-2431
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
551190
WV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5010234
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
01/17/2023
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