NPIMap

Organization Active NPI

South Carolina CVS Pharmacy LLC

Doing business as CVS Pharmacy #03541

  • Pharmacy
  • Anderson, SC
National Provider Identifier
1114020971
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
5004202 Issued in SC
Legal business name
SOUTH CAROLINA CVS PHARMACY LLC
Doing business as
CVS Pharmacy #03541
Practice address
109 Highway 28 Byp
Anderson, SC 29624-3743
Phone
(864) 296-9734
NPI assigned
Sep 7, 2006
Last updated
Feb 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 5004202 SC Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

109 Highway 28 Byp
Anderson, SC 29624-3743

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other names 1

  • CVS PHARMACY #03541 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101021000051 SC Part B Supplier - Mass Immunization (Roster Biller Only) 7214130400 This NPI is an additional NPI on the enrollment
O20110830000171 SC DME Supplier - Pharmacy 7214130400 Practice locations: Anderson, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2285082South Carolina CVS Pharmacy, LLC109 Highway 28 Bypass, Anderson, SC 29624Certificate of waiverJul 5, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
South Carolina CVS Pharmacy LLC109 Highway 28 Byp, Anderson, SC 29624-3743(864) 296-9734 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 assignmentParticipating since Jan 1, 2019

National Provider Directory

National Provider Directory
Tax ID family
South Carolina CVS Pharmacy181 organizations share this tax ID, including this one

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.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 357)

3513 Baker Rd NW
#500
Acworth, GA 30101
Phone (770) 917-0408

196 Alps Rd
Ste 20
Athens, GA 30606
Phone (706) 369-3490

395 North Ave
Athens, GA 30601
Phone (706) 546-6627

4044 Lexington Rd
Athens, GA 30605
Phone (706) 546-7903

1610 Mount Vernon Rd
Ste 100
Atlanta, GA 30338
Phone (770) 671-2797

2020 Campbellton Rd SW
#B
Atlanta, GA 30311
Phone (404) 758-4526

520 Boulevard SE
Atlanta, GA 30312
Phone (404) 624-0022

895 Ralph David Abernathy Blvd SW
Atlanta, GA 30310
Phone (404) 281-4574

1685 Atlanta Hwy NW
Auburn, GA 30011
Phone (770) 682-7053

3231 Wrightsboro Rd
Augusta, GA 30909
Phone (706) 738-2591

622 Rose Ave
Barnesville, GA 30204
Phone (678) 764-6431

1709 Gloucester St
Brunswick, GA 31520
Phone (912) 264-9442

5421 New Jesup Hwy
Brunswick, GA 31523
Phone (912) 264-1321

511 N Main St
Cedartown, GA 30125
Phone (770) 748-9944

308 Highway 441 S
Clayton, GA 30525
Phone (706) 782-2722

214 E 16th Ave
Cordele, GA 31015
Phone (229) 273-6551

603 Canton Rd
Cumming, GA 30040
Phone (770) 887-7771

6327 Highway 53 E
Dawsonville, GA 30534
Phone (706) 216-1303

2458 Candler Rd
Decatur, GA 30032
Phone (404) 284-9350

3820 N Decatur Rd
Decatur, GA 30032
Phone (404) 299-9154

4110 Pleasant Hill Rd
Duluth, GA 30096
Phone (770) 418-0510

535 Oak St
Eastman, GA 31023
Phone (478) 374-4593

809 Oak St
Eatonton, GA 31024
Phone (706) 485-5832

816 S Grant St
Fitzgerald, GA 31750
Phone (229) 423-6523

430 Tift College Dr
Forsyth, GA 31029
Phone (478) 994-0193

Practitioners & affiliated clinicians

Practitioners 154

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.

View all 154

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": "1328659200000",
    "number": "1114020971",
    "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": "109 HIGHWAY 28 BYP",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296243743",
            "telephone_number": "864-296-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2012-02-08",
        "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": "SC",
            "license": "5004202",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #03541",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.

Verify at the official NPI Registry.