Organization
NORTH CAROLINA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #01944
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
606 COLISEUM DR, WINSTON-SALEM, NC 27106-5311
(336) 727-8680
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
05
—
0347807
—
NC
01
—
3421257
NCPDP
NC
01
—
7705225
MEDICAID DME
NC
Enumeration date
08/25/2010
Last updated
05/24/2013
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