Organization
MAIN STREET PHARMACY, LLC
Active
Organization
MAIN STREET PHARMACY, LLC
Active
Other names
CVS Pharmacy #48369
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1600 WESTBROOK AVE, RICHMOND, VA 23227-3337
(804) 264-6245
(804) 264-6125
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201001586
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4843884
NCPDP
—
Enumeration date
05/14/2012
Last updated
06/30/2016
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