Organization
GEORGIA CVS PHARMACY L.L.C
Active
Other names
CVS PHARMACY #11017
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
500 POOLER PKWY, POOLER, GA 31322
(912) 748-5170
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
—
003185354A
—
GA
01
—
1169184
NCPDP #
GA
Enumeration date
01/06/2017
Last updated
05/03/2017
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