Organization
WEST VIRGINIA CVS PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIR PHCY ENROLLMENTS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
9781 SENECA TRL S, LEWISBURG, WV 24901-1580
(304) 645-7053
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
550100
WV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008532
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
10/31/2017
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