# CVS PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659654200
- **Authorized official:** KENNETH NORMAN TATUM SR. (PHARMACIST IN CHARGE)
- **Authorized official phone:** (910) 739-8144

## Contact information

- **Practice address:** 2771 W 5TH ST, LUMBERTON, NC 28358-7819
- **Practice address phone:** (910) 739-8144
- **Mailing address:** 2771 W 5TH ST, LUMBERTON, NC 28358-7819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 8804 | NC | Yes |

## Other

- **Enumeration date:** 09/20/2011
- **Last updated:** 09/20/2011