Organization
TENNESSEE CVS PHARMACY, LLC
Active
Other names
Erlanger Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F. COLBERT (SR. DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1200 DODSON AVE, CHATTANOOGA, TN 37406-3214
(423) 386-1107
(423) 698-8288
Mailing address
ONE CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TN
333600000X
Pharmacy
Primary
00000290
TN
3336C0003X
Community/Retail Pharmacy
00000290
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4423416
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
5777660169
MEDICARE B
TN
05
—
Q031380
—
TN
Enumeration date
12/01/2006
Last updated
07/21/2022
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