Organization
VIRGINIA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy # 10454
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1511 EMANCIPATION HWY, FREDERICKSBURG, VA 22401-4631
(540) 899-6874
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENT, 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
—
1720487150
—
VA
01
—
4845713
NCPDP
VA
Enumeration date
08/21/2014
Last updated
04/19/2022
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