Organization
GEORGIA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 00191
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5510 CASTLEBERRY RD, CUMMING, GA 30040-8054
(770) 887-7720
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
PHRE009058
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340306916C
—
GA
Enumeration date
08/29/2006
Last updated
07/09/2010
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