Active NPI
Virginia CVS Pharmacy, L.L.C.
Doing business as CVS Pharmacy # 04520
- Pharmacy
- Portsmouth, VA
National Provider Identifier
1811293012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- VIRGINIA CVS PHARMACY, L.L.C.
- Doing business as
- CVS Pharmacy # 04520
- Practice address
- 1800 Frederick Blvd
Portsmouth, VA 23707-4618 - Phone
- (757) 393-1120
- NPI assigned
- Feb 4, 2011
- Last updated
- Aug 26, 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 F Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1800 Frederick Blvd
Portsmouth, VA 23707-4618
Mailing address
1 CVS Dr
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4842680 | Other | VA | NCPDP |
| 1811293012 | Medicaid | VA |
Other names 1
- CVS Pharmacy # 04520
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 |
| O20110526000689 | VA | DME Supplier - Pharmacy | 5193727709 | Practice locations: Portsmouth, VA |
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.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Virginia CVS Pharmacy 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
- Virginia CVS Pharmacy 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.
-
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296777600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1314316800000",
"number": "1811293012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX 1075 - PHARMACY ENROLLMENTS",
"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": "1800 FREDERICK BLVD",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237074618",
"telephone_number": "757-393-1120"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIRGINIA CVS PHARMACY, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2011-02-04",
"last_updated": "2011-08-26",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"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": "NCPDP",
"identifier": "4842680",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1811293012",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy # 04520",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Portsmouth, VA
- Keira Viney, MASTER OF SW
- Shelton August Viola, M.D.
- Virginia Chiropractic Associates (Olde Towne Family Chiropractic)
- Virginia CVS Pharmacy LLC (CVS Pharmacy # 05501)
- Virginia CVS Pharmacy LLC (CVS Pharmacy # 10088)
- Virginia Eye Consultants Inc
- Earl Edward Virts III, CRNA
- Visions of Excellence, LLC
- Visiting Angels LLC
- Visiting Angels Medical Transportation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.