Organization
GEORGIA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy # 04571
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
92 S TALLAHASSEE ST, HAZLEHURST, GA 31539-6157
(912) 375-7729
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHRE004803
GA
333600000X
Pharmacy
Primary
PHRE004803
GA
3336C0003X
Community/Retail Pharmacy
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000111515A
—
GA
Enumeration date
01/16/2007
Last updated
01/17/2023
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