Organization
NORTH CAROLINA CVS PHARMACY, L.L.C
Active
Other names
CVS Pharmacy # 05420
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
770 W FIRE TOWER RD, WINTERVILLE, NC 28590-8411
(252) 321-0574
Mailing address
1 CVS DR, BOX 1075-PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
—
0746045
—
NC
01
—
3414199
NCPDP
—
01
—
7705135
MEDICAID DME
NC
Enumeration date
03/30/2009
Last updated
07/09/2013
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