Organization
GEORGIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 04507
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
103 JESSE JEWEL PKWY SW, GAINESVILLE, GA 30501-4321
(770) 536-3441
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
004074
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1101310
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
04/21/2022
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