Organization
VIRGINIA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #05802
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6099 INDIAN RIVER RD, VIRGINIA BEACH, VA 23464
(757) 938-9580
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
—
1477899318
—
VA
01
—
4844317
NCPDP
VA
Enumeration date
12/21/2012
Last updated
04/29/2013
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