CVS PHARMACY #04054
NPI 1265535082
Pharmacy in North Royalton, OH

Q: What is Ohio CVS Stores LLC's NPI number?

The NPI number for Ohio CVS Stores LLC is 1265535082. It was assigned to this organization in the NPPES registry on September 7, 2006. The provider is doing business as CVS Pharmacy #04054.

Q: What is Ohio CVS Stores LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Active since September 07, 2006CLIA 36D2279497 · Waiver

8001 W 130TH ST, NORTH ROYALTON, OH 44133(440) 845-6444 Get Directions Write a Review

NPPES record last updated: August 9, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Cvs Pharmacy #04054 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #04054 (NPI 1265535082) is a healthcare organization registered as a pharmacy in North Royalton, Ohio and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through April 2, 2027 and lists Susan Colbert, Director, as its authorized official.

NPPES Registry Identity

NPI1265535082

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameOHIO CVS STORES LLC

Location Address8001 W 130TH STNorth Royalton, OH 44133-1001

Mailing Address1 Cvs Dr, Po Box 1075Woonsocket, RI 02895-6146

Phone(440) 845-6444

Organization SubpartNo

Authorized OfficialSusan ColbertDirector · (401) 765-1500

Enumeration DateSeptember 7, 2006

Last NPPES UpdateAugust 9, 2011

✔ NPI 1265535082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in OH · 2758650

Definition

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X

8001 W 130TH ST, North Royalton, OH 44133

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Other Names 1

Doing Business AsCvs Pharmacy #04054

Other Identifiers 3

Medicare PINFV96411

Medicare NSC5660250184

Other3658878Other Id Number-commercial Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2279497

Ohio CVS Stores, LLC Cvs/Pharmacy #04054 · North Royalton, OH

Active · expires Apr 2, 2027

CLIA Number36D2279497

Laboratory TypePharmacy

Certificate Effective DateApril 3, 2025

Certificate Expiration DateApril 2, 2027

Laboratory DirectorJason Lucas

Laboratory Phone(440) 845-6444

Laboratory LocationOhio CVS Stores, LLC Cvs/Pharmacy #040548001 West 130th Street, North Royalton, OH 44133

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

274 services274 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

185 services185 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

70 services70 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

12 services12 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

12 services12 patients

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AMY SACULLA

Pharmacist