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GEORGIA CVS PHARMACY LLC NPI 1528302403


NPI Information

NPI: 1528302403
Provider Name: GEORGIA CVS PHARMACY LLC

Doing Business As: CVS PHARMACY #07689

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 11D2219567

Address:
1520 AVENUE PL
SUITE B-100
ATLANTA, GA
ZIP 30329
Phone: (404) 639-5575
Get Directions

GEORGIA CVS PHARMACY LLC is a pharmacy in Atlanta, GA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. GEORGIA CVS PHARMACY LLC NPI is 1528302403. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #07689.

The provider's business location address is:

1520 AVENUE PL
SUITE B-100
ATLANTA, GA
ZIP 30329-015
Phone: (404) 639-5575

The provider's authorized official is Susan Colbert .
The authorized official title is Director, Payer Relations and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 11D2219567 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/16/2012 and was last updated on 3/18/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesGEORGIANo
23336C0003XPharmacyCommunity/Retail PharmacyGEORGIANo
3333600000XPharmacyGEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15754010318MEDICARE NSCGEORGIA
21163017OTHERGEORGIANCPDP
3003131316AMEDICAIDGEORGIA
4202G738984MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.