Organization
NORTH CAROLINA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #02548
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-5721
Entity
Organization
Contact information
Practice address
13461 NC HWY 50, SURF CITY, NC 28445-6553
(910) 329-0484
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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0675752
—
NC
01
—
3458278
NCPDP
NC
01
—
7705259
MEDICAID DME
NC
Enumeration date
12/15/2010
Last updated
06/21/2011
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