Organization
GEORGIA CVS PHARMACY, LLC
Active
Other names
CVS Pharmacy #02593
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1193 US HIGHWAY 19 SOUTH, LEESBURG, GA 31763-4825
(229) 436-1330
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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003106836A
—
GA
01
—
1160770
NCPDP
GA
Enumeration date
12/17/2010
Last updated
03/06/2012
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