Organization
VIRGINIA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 04520
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1800 FREDERICK BLVD, PORTSMOUTH, VA 23707-4618
(757) 393-1120
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
—
1811293012
—
VA
01
—
4842680
NCPDP
VA
Enumeration date
02/04/2011
Last updated
08/26/2011
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