Organization
WEST VIRGINIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #06305
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1414 N EISENHOWER DR, BECKLEY, WV 25801-3124
(304) 255-0551
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
55075
WV
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013182004
—
WV
01
—
5000310
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
03/09/2012
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