Organization
GEORGIA CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #02236
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1600 TOWNE LAKE PKWY, WOODSTOCK, GA 30189-1585
(770) 517-1022
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
GA
333600000X
Pharmacy
Primary
008161
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000771185A
—
GA
01
—
1144409
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
10/21/2011
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