# GEORGIA CVS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS PHARMACY \# 07633
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821191693
- **Authorized official:** SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 1190 INDIAN TRAIL, NORCROSS, GA 30093-4594
- **Practice address phone:** (770) 638-8958
- **Mailing address:** 1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | GA | — |
| 333600000X | Pharmacy | 008043 | GA | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 09/08/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000723467A | — | GA |
| 01 | — | 1143217 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |