Active NPI
Ohio CVS Stores LLC
Doing business as CVS Pharmacy #06084
- Pharmacy
- Oxford, OH
National Provider Identifier
1386747095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 02-484950
- Legal business name
- OHIO CVS STORES LLC
- Doing business as
- CVS Pharmacy #06084
- Practice address
- 123 W Spring St
Oxford, OH 45056 - Phone
- (513) 523-6378
- NPI assigned
- Sep 7, 2006
- 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, Managed Care Admin
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 02-484950 | OH | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
123 W Spring St
Oxford, OH 45056
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3603998 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY #06084
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930024915 | OH | DME Supplier - Pharmacy | 4981806023 | Practice locations: Oxford, OH |
| O20101111000369 | OH | Part B Supplier - Mass Immunization (Roster Biller Only) | 4981806023 | This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2279471 | Ohio CVS Stores, LLC | Certificate of waiver | Apr 2, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Ohio CVS Stores LLC | 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 |
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.
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Oxford, OH
- NPI 1962891267
-
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Oxford, OH
- NPI 1952905317
-
- Pharmacist
- Oxford, OH
- NPI 1457954521
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": "1291248000000",
"number": "1386747095",
"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": "123 W SPRING ST",
"city": "OXFORD",
"state": "OH",
"postal_code": "45056",
"telephone_number": "513-523-6378"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OHIO CVS STORES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2010-12-02",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR, MANAGED CARE ADMIN",
"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": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OH",
"license": "02-484950",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3603998",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY #06084",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oxford, OH
- Emily Neal, CNP
- Danielle Nehring
- Nephrology Associates of Southwestern Ohio, Inc
- Northeast Ohio Neurological Services, LLC
- Shannon Lee O'Shea, LPN
- Oravelle Wellness LLC
- Oravelle Wellness LLC
- Orthopaedic Consultants of Cincinnati, Inc. (Wellington Orthopaedic and Sports Medicine)
- Lara C Osborne, LISW
- Marie Ashley Owens, ED.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.