Active NPI
North Carolina CVS Pharmacy LLC
Doing business as CVS Pharmacy #07317
- Pharmacy
- North Wilkesboro, NC
National Provider Identifier
1063515542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 6743
- Legal business name
- NORTH CAROLINA CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy #07317
- Practice address
- 240 Sparta Rd
North Wilkesboro, NC 28659-3122 - Phone
- (336) 667-0900
- NPI assigned
- Sep 7, 2006
- Last updated
- Oct 7, 2011
- 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
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 6743 | NC | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
240 Sparta Rd
North Wilkesboro, NC 28659-3122
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3420104 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY #07317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080116000795 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 9133200017 | This NPI is an additional NPI on the enrollment |
| O20110525000074 | NC | DME Supplier - Pharmacy | 9133200017 | Practice locations: North Wilkesboro, NC |
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 |
|---|---|---|
| North Carolina CVS Pharmacy LLC | Immunosuppressive Drugs|Infusion 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|Urologic… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- North Carolina CVS Pharmacy
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Pharmacist
- Fayetteville, NC
- NPI 1083001671
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
240 Sparta Rd
North Wilkesboro, NC 28659
Phone (336) 667-0900
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": "1317945600000",
"number": "1063515542",
"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": "240 SPARTA RD",
"city": "NORTH WILKESBORO",
"state": "NC",
"postal_code": "286593122",
"telephone_number": "336-667-0900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH CAROLINA CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2011-10-07",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NC",
"license": "6743",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3420104",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY #07317",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in North Wilkesboro, NC
- New River Service Authority (New River Behavioral HealthCare)
- Ashley Michelle Nichols, LCAS
- Gary Glenn Nichols, P.A.
- NMG Affiliate Practice I, LLC (Novant Health Oncology Specialists)
- Mary J Noland, LPN; PTA
- Northland Hearing Centers, Inc. (Best Value Hearing Care Center)
- Novant Health Medical Group, LLC (Novant Health Orthopedics & Sports Medicine)
- Novant Health Medical Group, LLC (Novant Health Diabetes Management Wilkesboro)
- Novant Health Medical Group, LLC (Novant Health Wilkes Medical Associates)
- Ntboyer LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.