Active NPI
South Carolina CVS Pharmacy LLC
Doing business as CVS Pharmacy #05476
- Pharmacy
- Lancaster, SC
National Provider Identifier
1003919598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 5004200
- Legal business name
- SOUTH CAROLINA CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy #05476
- Practice address
- 1869 Great Falls Highway
Lancaster, SC 29720-7172 - Phone
- (803) 285-8491
- NPI assigned
- Sep 7, 2006
- Last updated
- Aug 12, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Sr. Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | 5004200 | SC | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
1869 Great Falls Highway
Lancaster, SC 29720-7172
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4218168 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY #05476
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101021000051 | SC | Part B Supplier - Mass Immunization (Roster Biller Only) | 7214130400 | This NPI is an additional NPI on the enrollment |
| O20110819000457 | SC | DME Supplier - Pharmacy | 7214130400 | Practice locations: Lancaster, SC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| South Carolina CVS Pharmacy LLC | Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Ent… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- South Carolina CVS Pharmacy LLC
Organizations with this tax ID in the same state 12
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba CVS Pharmacy #05044
- Pharmacy
- Myrtle Beach, SC
- NPI 1033213848
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
1869 Great Falls Hwy
Lancaster, SC 29720
Phone (803) 285-8491
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Lancaster, SC
- NPI 1841914900
-
- Pharmacist
- Lancaster, SC
- NPI 1427692839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1470960000000",
"number": "1003919598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1869 GREAT FALLS HIGHWAY",
"city": "LANCASTER",
"state": "SC",
"postal_code": "297207172",
"telephone_number": "803-285-8491"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH CAROLINA CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2016-08-12",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "SC",
"license": "5004200",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "4218168",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY #05476",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lancaster, SC
- Brittany Leigh Smith, PA-C
- John Thomas Smith, M.D.
- Drasti Patel Smyre, PA-C
- Sruthi Sooryanarayanan, MD
- Alyssa Marie Soprano, DNP
- South Carolina CVS Pharmacy LLC (CVS Pharmacy #07005)
- South Carolina Dhec (Catawba CRS)
- South Carolina Em-I Medical Services, PC
- South Carolina Podiatric Physicians and Surgeons Group, LLC
- Southern Comfort Anesthesia, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.