North Carolina CVS Pharmacy LLC
Organization Active NPI Pharmacy · Clayton, NC
NPI 1124434865 · NPPES record last updated Aug 15, 2024
Key facts
- NPI
- 1124434865
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- NORTH CAROLINA CVS PHARMACY LLC
- Practice address
- 32 Village Center Dr
Clayton, NC 27527 - Phone
- (919) 550-2494
- NPI assigned
- Jul 2, 2014
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Sr. Director, Payer Relations
- Phone
- (401) 765-1500
Corporate family (same tax ID) 24
Member of 1
Practitioners 3
-
Kaylee Morgan Nalls, PHARMD
-
Meredith Myers Smith, PHARMD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2282520 | North Carolina CVS Pharmacy, LLC Dba | Certificate of waiver | May 22, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #10481 |
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 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC
Medicare enrollment records
| 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 |
| O20141023002087 | NC | DME Supplier - Pharmacy | 9133200017 | Practice locations: Clayton, NC |
National Provider Directory
- Tax ID family
- North Carolina CVS Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NC | ||
| Pharmacy | 333600000X | NC | Yes | |
| Community/Retail Pharmacy | 3336C0003X | NC |
Addresses
Primary practice location
32 Village Center Dr
Clayton, NC 27527
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other names
- CVS PHARMACY # 10481
Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.