Tennessee CVS Pharmacy, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

00000290 Issued in TN

Legal business name

TENNESSEE CVS PHARMACY, LLC

Practice address

1200 Dodson Ave
Chattanooga, TN 37406-3214

Phone

(423) 386-1107

Fax

(423) 698-8288

NPI assigned

Dec 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan F. Colbert

Title

Sr. Director

Phone

(401) 765-1500

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Erlanger Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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

Member of 1

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

• CVS Pharmacy Inc

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154499952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE CVS DRIVE",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500",
            "fax_number": "401-770-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 DODSON AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374063214",
            "telephone_number": "423-386-1107",
            "fax_number": "423-698-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE CVS PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "SR. DIRECTOR",
        "authorized_official_telephone_number": "401-765-1500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "00000290",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "00000290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "5777660169",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4423416",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q031380",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Erlanger Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC
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• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy, L.L.C.
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• Tennessee Hypertension Network, PC
• Tennessee Institute for Maxillofacial Surgery, LLC
• Tennessee Interventional and Imaging Associates, PLLC

• Pharmacy in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.