Organization
GEORGIA CVS PHARMACY, LLC
Active
Other names
CVS Pharmacy # 08907
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
395 JACKSON ST, NEWNAN, GA 30263
(770) 251-3857
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
—
003106839A
—
GA
01
—
1160744
NCPDP
—
Enumeration date
12/10/2010
Last updated
03/07/2012
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