Active NPI
North Carolina CVS Pharmacy, L.L.C.
Doing business as CVS Pharmacy #11349
- Community/Retail Pharmacy
- Swansboro, NC
National Provider Identifier
1255564308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 10348
- Legal business name
- NORTH CAROLINA CVS PHARMACY, L.L.C.
- Doing business as
- CVS Pharmacy #11349
- Practice address
- 1106B Main St Ext
Swansboro, NC 28584-9114 - Phone
- (910) 708-5008
- Fax
- (910) 326-6622
- NPI assigned
- Aug 24, 2009
- Last updated
- Aug 26, 2019
- 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 F Colbert
- Title
- Sr. Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 10348 | NC | Primary |
Addresses
Primary practice location
1106B Main St Ext
Swansboro, NC 28584-9114
Mailing address
1 CVS Drive
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2121722 | Other | PK |
Other names 1
- CVS Pharmacy #11349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 2
| 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 |
| O20190917002178 | NC | DME Supplier - Pharmacy | 9133200017 | Practice locations: Swansboro, NC |
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 |
|---|---|---|
| North Carolina CVS Pharmacy LLC | 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 |
National Provider Directory
National Provider Directory- Tax ID family
- North Carolina CVS Pharmacy
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.
Locations
1106B Main Street Ext
Swansboro, NC 28584
Phone (910) 326-6600
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Henderson, NC
- NPI 1891170320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251072000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566777600000",
"number": "1255564308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DRIVE",
"address_2": "BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500",
"fax_number": "910-326-6622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1106B MAIN ST EXT",
"city": "SWANSBORO",
"state": "NC",
"postal_code": "285849114",
"telephone_number": "910-708-5008",
"fax_number": "910-326-6622"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH CAROLINA CVS PHARMACY, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2009-08-24",
"last_updated": "2019-08-26",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NC",
"license": "10348",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2121722",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #11349",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Swansboro, NC
- Ryan Kristopher McKinney, NRP
- Med First Immediate Care & Family Practice PA
- Meredith Raine Meilleur, RN
- Mindful Wellness Counseling, PC
- Neighborhood Podiatry
- Ohanas Connection LLC
- Jessica Robyn Oneil, OD
- Onslow Opco Holdings LLC (The Landings of Swansboro)
- Leah Belle Otte, MSW, LCSW
- Holly M Peck, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.