Organization
SOUTH CAROLINA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 03203
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
35 S MAIN ST, GREENVILLE, SC 29601-2708
(864) 370-4848
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13488
PHARMACY STATE LICENSE
SC
01
—
4230328
NCPDP
—
05
—
713488
—
SC
Enumeration date
07/27/2011
Last updated
03/07/2023
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