Active NPI
South Carolina CVS Pharmacy, L.L.C.
Doing business as CVS Pharmacy # 00626
- Pharmacy
- North Charleston, SC
National Provider Identifier
1114152204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- SOUTH CAROLINA CVS PHARMACY, L.L.C.
- Doing business as
- CVS Pharmacy # 00626
- Practice address
- 8995 University Blvd
North Charleston, SC 29406-9116 - Phone
- (843) 414-0710
- NPI assigned
- May 19, 2009
- Last updated
- Feb 8, 2012
- 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 | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
8995 University Blvd
North Charleston, SC 29406-9116
Mailing address
1 CVS Dr
Box-1075 Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other names 1
- CVS PHARMACY # 00626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930058702 | SC | DME Supplier - Pharmacy | 7214130400 | Practice locations: North Charleston, SC |
| O20101021000051 | SC | Part B Supplier - Mass Immunization (Roster Biller Only) | 7214130400 | This NPI is an additional NPI on the enrollment |
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 |
|---|---|---|
| CVS Pharmacy #00626 | 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 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242691200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1328659200000",
"number": "1114152204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX-1075 PHARMACY ENROLLMENTS",
"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": "8995 UNIVERSITY BLVD",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294069116",
"telephone_number": "843-414-0710"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH CAROLINA CVS PHARMACY, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2009-05-19",
"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": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY # 00626",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in North Charleston, SC
- Hanan Sokol, ATC
- Grace Song, MD
- Melissa Sue Soule, MA
- South Carolina CVS Pharmacy LLC (CVS Pharmacy #16950)
- South Carolina CVS Pharmacy LLC (CVS Pharmacy #03977)
- South Carolina Dept of Mental Health Accounting Office (Tricounty Crisis Stabilization Center)
- South Carolina Dhec (Diabetes Education Program Trident)
- South Carolina PHS PC
- Terri Southard, MS, LPC
- Bonita A Spade, FNP,CDE
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.