Active NPI
West Virginia CVS Pharmacy LLC
Doing business as CVS Pharmacy 05957
- Pharmacy
- Elkview, WV
National Provider Identifier
1871696534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 551216
- Legal business name
- WEST VIRGINIA CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy 05957
- Practice address
- 221 Crossing Mall Rd.
Elkview, WV 25071-9230 - Phone
- (304) 965-0460
- NPI assigned
- Sep 7, 2006
- Last updated
- Jan 17, 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 Colbert
- Title
- Director
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | 551216 | WV | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
221 Crossing Mall Rd.
Elkview, WV 25071-9230
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5010424 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY 05957
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 WV
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101028001521 | WV | Part B Supplier - Mass Immunization (Roster Biller Only) | 2668678681 | This NPI is an additional NPI on the enrollment |
| O20110705000119 | WV | DME Supplier - Pharmacy | 2668678681 | Practice locations: Elkview, WV |
National Provider Directory
National Provider Directory- Tax ID family
- West Virginia CVS Pharmacy LLC
Organizations with this tax ID in the same state 17
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
- Bridgeport, WV
- NPI 1659393353
-
- Pharmacy
- Lewisburg, WV
- NPI 1699878355
-
dba Target Pharmacy
- Community/Retail Pharmacy
- Barboursville, WV
- NPI 1740202449
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
221 Crossings Mall Rd
Elkview, WV 25071
Phone (304) 965-0460
Practitioners & affiliated clinicians
Practitioners 2
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
- Elkview, WV
- NPI 1699380113
-
- Pharmacist
- Elkview, WV
- NPI 1194339523
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": "1673913600000",
"number": "1871696534",
"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": "221 CROSSING MALL RD.",
"city": "ELKVIEW",
"state": "WV",
"postal_code": "250719230",
"telephone_number": "304-965-0460"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST VIRGINIA CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "WV",
"license": "551216",
"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": "5010424",
"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 05957",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CVS PHARMACY 05957",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Elkview, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.