Ohio CVS Stores LLC
Organization Active NPI Community/Retail Pharmacy · Willoughby, OH
NPI 1992727705 · NPPES record last updated Aug 25, 2016
Key facts
- NPI
- 1992727705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- RTPC.022570500-03 (OH)
- Legal business name
- OHIO CVS STORES LLC
- Practice address
- 36195 Euclid Ave
Willoughby, OH 44094-4410 - Phone
- (440) 975-1983
- Fax
- (440) 520-7148
- NPI assigned
- Jul 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Sr. Director, Payer Relations
- Phone
- (401) 770-2751
Corporate family (same tax ID) 17
Member of 1
Laboratory certificates & supplier records
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 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH
Medicare enrollment records
| 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 |
| O20161101000543 | OH | DME Supplier - Pharmacy | 4981806023 | Practice locations: Willoughby, OH |
National Provider Directory
- Tax ID family
- CVS Pharmacy 05364
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | RTPC.022570500-03 | OH | Yes |
Addresses
Primary practice location
36195 Euclid Ave
Willoughby, OH 44094-4410
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2075279 | Other | PK |
Other names
- CVS Pharmacy #
Other providers in Willoughby, OH
- Nancy Teresa O'Maille
- Concetta Occhipinti Kless
- Occupational Health Centers of Ohio, P.a., Co.
- Thomas Karl Ockler
- Ohio CVS Stores LLC
- Ohio Em-I Medical Services, Professional Association
- Ohio Living Communities
- Ohio Living Communities
- Ohio Living Holdings
- Ohio Living Holdings
All providers in Willoughby, OH · Community/Retail Pharmacy in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.