# TENNESSEE CVS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS PHARMACY \#06628
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346544921
- **Authorized official:** SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 786 N GERMANTOWN PKWY, CORDOVA, TN 38018-6212
- **Practice address phone:** (901) 755-7696
- **Mailing address:** 1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

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

## Other

- **Enumeration date:** 12/22/2010
- **Last updated:** 03/02/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1523191 | DME MEDICAID | TN |
| 01 | — | 4443862 | NCPDP | TN |