Tennessee CVS Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

TENNESSEE CVS PHARMACY LLC

Practice address

11100 Parkside Dr
Knoxville, TN 37934-1960

Phone

(865) 675-8180

Fax

(865) 675-8180

NPI assigned

Jul 24, 2006

Organization subpart

No

Name

Susan Colbert

Title

Sr. Director, Payer Relations

Phone

(401) 770-2751

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

• CVS Pharmacy Inc

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366
  NPD member Member Of

These 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

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

• CVS Pharmacy #16709 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 9, 2016.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1124040878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "MAIL CODE 1090",
            "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": "11100 PARKSIDE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341960",
            "telephone_number": "865-675-8180",
            "fax_number": "865-675-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-12-09",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "3771",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2093239",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #16709",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tennessee Cancer Specialists, PLLC
• Tennessee Cancer Specialists, PLLC
• Tennessee Cancer Specialists, PLLC
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• Tennessee Children'S Home
• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC

• All providers in Knoxville, TN
• Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.

Verify at the official NPI Registry.