# TENNESSEE CVS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS Pharmacy \#07655
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265535819
- **Authorized official:** SUSAN F COLBERT (SR DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (800) 764-7287

## Contact information

- **Practice address:** 1161 US HWY 19 E, ELIZABETHTON, TN 37643-4680
- **Practice address phone:** (423) 547-1991
- **Practice address fax:** (423) 547-0110
- **Mailing address:** 1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500
- **Mailing address fax:** (401) 735-1080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | — | — |
| 333600000X | Pharmacy | 3189 | TN | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 05/02/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4430839 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |