Organization
OHIO CVS STORES LLC
Active
Other names
CVS PHARMACY #07777
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2812 SCIOTO TRL, PORTSMOUTH, OH 45662-2244
(740) 355-3568
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
02-1072150
OH
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2066188
—
OH
01
—
3665479
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
710003989000
—
KY
Enumeration date
09/20/2006
Last updated
01/18/2023
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