Organization
GEORGIA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 03878
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
680 PONCE DE LEON AVE., ATLANTA, GA 30308-1808
(404) 892-1164
Mailing address
1 CVS DR, 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
05
—
022124339A
—
GA
01
—
1159955
NCPDP
GA
Enumeration date
06/10/2010
Last updated
06/04/2014
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