South Carolina CVS Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

5004509 Issued in SC

Legal business name

SOUTH CAROLINA CVS PHARMACY LLC

Practice address

1210 Wilson Rd
Newberry, SC 29108-4008

Phone

(803) 276-6350

NPI assigned

Sep 7, 2006

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• CVS PHARMACY #03542 Doing business as

Medicare fee-for-service enrollment

Enrolled in SC2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

South Carolina CVS Pharmacy LLC180 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.

• CVS Pharmacy

  • Community/Retail Pharmacy
  • Columbia, SC
  • NPI 1255680138
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Goose Creek, SC
  • NPI 1164525606
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Mount Pleasant, SC
  • NPI 1174175038
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Indian Land, SC
  • NPI 1174406573
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Piedmont, SC
  • NPI 1174626857
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Aiken, SC
  • NPI 1205939063
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Saluda, SC
  • NPI 1205939071
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Manning, SC
  • NPI 1215030085
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Florence, SC
  • NPI 1215030705
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Gaffney, SC
  • NPI 1215031026
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Boiling Springs, SC
  • NPI 1215779327
  NPD tax ID
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Spartanburg, SC
  • NPI 1235232901
  NPD tax ID

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": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1235232000",
    "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": "1210 WILSON RD",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291084008",
            "telephone_number": "803-276-6350"
        }
    ],
    "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": "5004509",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4201769",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #03542",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adrian Sinclair, RN
• Sleepmed,Inc
• Cassandra Louise Sligh Dewalt Conway, LPC-A, LEADING TOLPC
• Amari Kayla Smith
• Kevin Smith, PHARM. D
• Timothy A Stafford, O.D.
• State of South Carolina
• State of South Carolina
• Ashley Worrall Stewart, PHARM.D.
• Pam S Stuck, RN

• All providers in Newberry, SC
• Pharmacy in South Carolina

• 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.