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GEORGIA CVS PHARMACY LLC NPI 1821191693


NPI Information

NPI: 1821191693
Provider Name: GEORGIA CVS PHARMACY LLC

Doing Business As: CVS PHARMACY # 07633

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 11D2282584

Address:
1190 INDIAN TRAIL
NORCROSS, GA
ZIP 30093
Phone: (770) 638-8958
Get Directions

GEORGIA CVS PHARMACY LLC is a pharmacy in Norcross, 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 1821191693. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy # 07633.

The provider's business location address is:

1190 INDIAN TRAIL
NORCROSS, GA
ZIP 30093-594
Phone: (770) 638-8958

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 11D2282584 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 9/8/2011.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesGEORGIANo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy008043GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15754010248MEDICARE NSC
21143217OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3202G738984MEDICARE PINGEORGIA
4000723467AMEDICAIDGEORGIA

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: 5/5/2024

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