# GEORGIA CVS PHARMACY, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS Pharmacy \# 04147
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831380039
- **Authorized official:** SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 5815 CAMPBELLTON RD SW, ATLANTA, GA 30331-8046
- **Practice address phone:** (404) 346-4164
- **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 | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 04/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1155957 | NCPDP | GA |
| 05 | — | 908463150A | — | GA |