Organization
GEORGIA CVS PHARMACY L.L.C.
Active
Other names
CVS Pharmacy #05071
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
3709 THOMPSON BRIDGE RD., GAINESVILLE, GA 30506
(770) 503-7454
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
01
—
1157595
NCPDP
GA
05
—
950343218A
—
GA
Enumeration date
08/06/2008
Last updated
03/08/2011
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