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Organization
GEORGIA CVS PHARMACY LLC
Active
Organization
GEORGIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 04515
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
14857 US HIGHWAY 19 S, THOMASVILLE, GA 31792-4870
(912) 228-7785
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
—
NULL
333600000X
Pharmacy
Primary
004059
GA
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004311600
—
FL
01
—
1101384
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
01/17/2023
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