Organization
GA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN PINETTE (TP PHARMACY ENROLLMENT)
(401) 770-1500
Entity
Organization
Contact information
Practice address
4250 ROSWELL RD NE, MARIETTA, GA 30062
(770) 565-4064
Mailing address
4250 ROSWELL RD NE, MARIETTA, GA 30062
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1155250
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/18/2006
Last updated
08/22/2020
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