Organization
WEST VIRGINIA CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #10364
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR-PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
496 HIGH ST, MORGANTOWN, WV 26505-5529
(304) 284-0499
(304) 284-0143
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
—
WV
333600000X
Pharmacy
Primary
—
WV
3336C0003X
Community/Retail Pharmacy
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390006880
—
WV
01
—
5056343
NCPDP
WV
Enumeration date
01/06/2015
Last updated
07/27/2015
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