Organization
VIRGINIA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy # 10088
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5829 HIGH ST W, PORTSMOUTH, VA 23703-4503
(757) 686-6980
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
—
1952720740
—
VA
01
—
4845218
NCPDP
VA
Enumeration date
04/09/2014
Last updated
07/29/2014
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