Organization
WEST VIRGINIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 01308
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
46 MIDDLEWAY PIKE, INWOOD, WV 25428-3713
(304) 229-4318
Mailing address
ONE CVS DRIVE, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895
(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
—
3810011632
—
WV
01
—
5054717
OTHER COMMERCIAL IDENTIFIER - NCPDP NUMBER
—
Enumeration date
03/17/2008
Last updated
09/24/2012
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