Organization
TENNESSEE CVS PHARMACY LLC
Active
Other names
CVS PHARMACY# 11071
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
116 COMMONS DR, MARTIN, TN 38237-3879
(731) 587-9509
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
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4448785
NCPDP
TN
Enumeration date
04/13/2016
Last updated
01/19/2023
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