Active NPI
Virginia CVS Pharmacy LLC
Doing business as CVS Pharmacy # 03508
- Pharmacy
- Martinsville, VA
National Provider Identifier
1790888428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 0201000707
- Legal business name
- VIRGINIA CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy # 03508
- Practice address
- 762 Echurch St
Martinsville, VA 24112 - Phone
- (276) 632-9804
- NPI assigned
- Sep 7, 2006
- Last updated
- Jan 12, 2023
- 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 F Colbert
- Title
- Exec Dir, RX Services
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | 0201000707 | VA | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
762 Echurch St
Martinsville, VA 24112
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4804200 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY # 03508
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070212000316 | VA | Part B Supplier - Mass Immunization (Roster Biller Only) | 5193727709 | This NPI is an additional NPI on the enrollment |
| O20110729000095 | VA | DME Supplier - Pharmacy | 5193727709 | Practice locations: Martinsville, VA |
National Provider Directory
National Provider Directory- Tax ID family
- Virginia CVS Pharmacy L L C
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.
-
dba Target Pharmacy
- Community/Retail Pharmacy
- Fredericksburg, VA
- NPI 1801080932
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
762 E Church St
Martinsville, VA 24112
Phone (276) 632-9804
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": "1673481600000",
"number": "1790888428",
"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",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "762 ECHURCH ST",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "24112",
"telephone_number": "276-632-9804"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIRGINIA CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2023-01-12",
"certification_date": "2023-01-12",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "EXEC DIR, RX SERVICES",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "VA",
"license": "0201000707",
"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": "4804200",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "CVS PHARMACY # 03508",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CVS PHARMACY # 03508",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Martinsville, VA
- Samantha Lynn Vargas, CMA
- Kendall Varner, PT, DPT
- Ariel Christina Vaughn, LCSW
- John Henry Velyvis, M.D.
- Barbara L Vigue, CRNA
- Virginia CVS Pharmacy LLC (CVS Pharmacy #04363)
- Virginia in-Home Partner-VI, LLC (Commonwealth Healthcare at Home)
- Virginia Prosthetics Inc (Formotion Clinic)
- Visions 4 Youth Homes
- Vistar Eye Center, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.