Organization
GEORGIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 08395
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2720 HIGHWAY 42 N, MCDONOUGH, GA 30253-4301
(678) 432-9450
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
—
GA
333600000X
Pharmacy
Primary
—
GA
3336C0003X
Community/Retail Pharmacy
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154929
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
340306916D
—
GA
Enumeration date
10/23/2006
Last updated
06/08/2011
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