Organization
GEORGIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 06861
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
441 FAIR RD, STATESBORO, GA 30458-4913
(912) 489-0943
Mailing address
ONE CVS DRIVE, 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
—
003130583A
—
GA
01
—
1163031
NCPDP
GA
Enumeration date
11/16/2012
Last updated
11/21/2013
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