Organization
GEORGIA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 04567
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5421 NEW JESUP HWY, BRUNSWICK, GA 31523-1137
(912) 264-1321
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
004827
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000113187A
—
GA
01
—
1121413
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
09/08/2011
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