Ohio CVS Stores LLC
NPI 1083717805ActiveOrganization· Pharmacy· Avon Lake, OH
Pharmacy in Avon Lake, Ohio, registered in NPPES in September 2006. The authorized official on file is Susan Colbert, Director. Medicare paid $97,307 for services to 379 patients in 2024.
Overview
| NPI | 1083717805 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 7, 2006 |
| Last updated in NPPES | Mar 8, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 2758900 | OH |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (OH) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 379 |
|---|---|
| Services billed | 1,270 across 10 procedure codes |
| Paid by Medicare | $97,307 |
Other Pharmacy providers in Avon Lake
- 1639676141
- 1982619912