Organization
SOUTH CAROLINA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #04395
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
10599 DORCHESTER RD, SUMMERVILLE, SC 29485-8047
(843) 871-7701
(843) 875-9242
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
50004370
SC
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4209741
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
02/08/2012
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