NPIMap

Ohio CVS Stores LLC

Organization Active NPI Community/Retail Pharmacy · Powell, OH

NPI 1154721264 · NPPES record last updated Aug 25, 2016

Key facts

NPI
1154721264
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
RTPC.022572550-03 (OH)
Legal business name
OHIO CVS STORES LLC
Practice address
10560 Sawmill Rd
Powell, OH 43065
Phone
(614) 356-4367
NPI assigned
Aug 26, 2014
Organization subpart
No

Authorized official

Name
Susan Colbert
Title
Sr. Director, Payer Relations
Phone
(401) 770-2751

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #17666
10560 Sawmill Pkwy, Powell, OH 43065-7864 · (614) 356-4367		 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… Does not accept assignment
Participating since Jan 1, 2019

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20101111000369 OH Part B Supplier - Mass Immunization (Roster Biller Only) 4981806023 This NPI is an additional NPI on the enrollment
O20161020001264 OH DME Supplier - Pharmacy 4981806023 Practice locations: Powell, OH

National Provider Directory

Tax ID family
CVS Pharmacy 05364 (311 organizations share this tax ID)

Locations

10560 Sawmill Rd
Powell, OH 43065
Phone (614) 356-4367

10560 Sawmill Pkwy
Powell, OH 43065
Phone (614) 356-4367

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X RTPC.022572550-03 OH Yes

Addresses

Primary practice location

10560 Sawmill Rd
Powell, OH 43065

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers

IdentifierTypeStateIssuer
2147391OtherPK

Other names

  • CVS Pharmacy # Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 25, 2016.

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1154721264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500",
            "fax_number": "612-696-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 SAWMILL RD",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "43065",
            "telephone_number": "614-356-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO CVS STORES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-26",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "RTPC.022572550-03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147391",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Powell, OH

All providers in Powell, OH · Community/Retail Pharmacy in Ohio

Sources for this page

Verify at the official NPI Registry.