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GEORGIA CVS PHARMACY LLC NPI 1669554804


NPI Information

NPI: 1669554804
Provider Name: GEORGIA CVS PHARMACY LLC

Doing Business As: CVS PHARMACY #17254

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 11D2219420

Address:
2195 HIGHWAY 20 SE
CONYERS, GA
ZIP 30013
Phone: (770) 785-6471
Get Directions

GEORGIA CVS PHARMACY LLC is a pharmacy in Conyers, 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 1669554804. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #17254.

The provider's business location address is:

2195 HIGHWAY 20 SE
CONYERS, GA
ZIP 30013-028
Phone: (770) 785-6471
Fax: (770) 761-1045

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

The CLIA number assigned to this NPI record is 11D2219420 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 10/31/2016.


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
13336C0003XPharmacyCommunity/Retail PharmacyPHRE010239GEORGIANo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacyYes

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
15754010348MEDICARE NSC
22016336OTHERPK

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

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