Organization
SOUTH CAROLINA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #05475
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1200 E BUTLER RD, GREENVILLE, SC 29607-5910
(864) 297-2501
(864) 284-6346
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
5004074
SC
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000027219
—
SC
01
—
4217952
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
01/31/2021
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