Active NPI
Ohio CVS Stores LLC
Doing business as CVS Pharmacy 07687
- Pharmacy
- Shaker Heights, OH
National Provider Identifier
1184727646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 20983300
- Legal business name
- OHIO CVS STORES LLC
- Doing business as
- CVS Pharmacy 07687
- Practice address
- 20641 Fairmount Blvd
Shaker Heights, OH 44118-4835 - Phone
- (216) 371-1234
- NPI assigned
- Sep 7, 2006
- Last updated
- Aug 9, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Director,Payer Relations
- Phone
- (401) 770-7751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | 20983300 | OH | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
20641 Fairmount Blvd
Shaker Heights, OH 44118-4835
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3663374 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY 07687
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101111000369 | OH | Part B Supplier - Mass Immunization (Roster Biller Only) | 4981806023 | This NPI is an additional NPI on the enrollment |
| O20110629000107 | OH | DME Supplier - Pharmacy | 4981806023 | Practice locations: Shaker Heights, OH |
National Provider Directory
National Provider Directory- Tax ID family
- Ohio CVS Stores LLC
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1312848000000",
"number": "1184727646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "PO BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20641 FAIRMOUNT BLVD",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441184835",
"telephone_number": "216-371-1234"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OHIO CVS STORES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2011-08-09",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR,PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-7751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OH",
"license": "20983300",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3663374",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY 07687",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Shaker Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.