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Organization
GEORGIA CVS PHARMACY LLC
Active
Organization
GEORGIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY 04389
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
6 W MAY ST, WINDER, GA 30680-8105
(770) 867-7407
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
005160
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1122934
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
P00814032
MEDICARE RR
—
Enumeration date
09/07/2006
Last updated
09/08/2011
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