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Export Provider Record NPI 1417050170
West Virginia Cvs Pharmacy Llc
Organization Subpart: NO
Active
NPI Number1417050170
NPI TypeNPI-2 Organization
SpecialtyPharmacy
Provider Details
NPI1417050170
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-09-07
Last Updated2023-01-17
Authorized OfficialSusan Colbert
Director
Phone: 4017651500
Mailing Address1 Cvs Dr, Po Box 1075
Woonsocket, RI 02895-6146
United States
📍 View Map
Primary Practice Address300 4th Ave
Montgomery, WV 25136-2204
United States
Phone: (304) 442-2431
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)-5010234Other ID Number-Commercial Number
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies--
No3336C0003X – Pharmacy, Community/Retail Pharmacy--
Yes333600000X – PharmacyWV551190
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About NPI 1417050170

West Virginia Cvs Pharmacy Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1417050170. The primary specialty listed is Pharmacy. The organization is located in Montgomery, WV. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-09-07. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1417050170?

NPI 1417050170 belongs to West Virginia Cvs Pharmacy Llc, a Pharmacy in Montgomery, WV. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1417050170 active?

The current status of NPI 1417050170 in the NPPES registry is Active. The record was last updated on 2023-01-17.

What specialty is NPI 1417050170?

NPI 1417050170 is classified under the taxonomy Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1417050170?

You can verify NPI 1417050170 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1417050170?

The primary practice address on file for NPI 1417050170 is 300 4th Ave, Montgomery, WV 25136-2204. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1417050170 issued?

NPI 1417050170 was first issued (enumerated) on 2006-09-07. The NPPES record was last updated on 2023-01-17.

Practice Location Map

West Virginia Cvs Pharmacy Llc is located at 300 4th Ave, Montgomery, WV. Use the map below to find directions or verify the practice location.

📍 300 4th Ave, Montgomery, WV 25136-2204  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as West Virginia Cvs Pharmacy Llc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1417050170. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy551190WV
Data Verified from CMS NPPES Last synced: 2026-08-27 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162