Organization
GEORGIA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 05731
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
3221 PEACHTREE ROAD NE, ATLANTA, GA 30305-2414
(404) 869-3308
Mailing address
PO BOX A3649, CHICAGO, IL 60690-3649
(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
—
111782191A
—
GA
01
—
1158597
NCPDP
GA
Enumeration date
04/08/2009
Last updated
03/08/2011
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