Organization
GEORGIA CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #08424
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6201 LAKE OCONEE PKWY, GREENSBORO, GA 30642-6410
(706) 453-9094
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
—
—
333600000X
Pharmacy
Primary
PHRE008935
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1153078
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
160065876A
—
GA
Enumeration date
09/12/2006
Last updated
10/25/2011
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