Georgia CVS Pharmacy, L.L.C.

Primary specialty

PharmacyTaxonomy code 333600000X

License

008186 Issued in GA

Legal business name

GEORGIA CVS PHARMACY, L.L.C.

Practice address

2935 Five Forks Trickum Rd
Lawrenceville, GA 30044-5895

Phone

(770) 982-5202

NPI assigned

Sep 12, 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 # 02103 Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 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

CVS Pharmacy 06861290 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.

• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Hull, GA
  • NPI 1346343191
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Savannah, GA
  • NPI 1346343803
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Stockbridge, GA
  • NPI 1356444194
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Dalton, GA
  • NPI 1356444715
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Griffin, GA
  • NPI 1366545121
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Smyrna, GA
  • NPI 1396767182
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Lagrange, GA
  • NPI 1396848057
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Hinesville, GA
  • NPI 1396849238
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Augusta, GA
  • NPI 1407040413
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Warner Robins, GA
  • NPI 1407878291
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Bremen, GA
  • NPI 1417050253
  NPD tax ID
• Georgia CVS Pharmacy LLC

  • Pharmacy
  • Saint Marys, GA
  • NPI 1427151265
  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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1376647206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "PO 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": "2935 FIVE FORKS TRICKUM RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445895",
            "telephone_number": "770-982-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2012-03-05",
        "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": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "008186",
            "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": "1144601",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY # 02103",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Georgia Comprehensive Family Clinic and Natural Health
• Georgia CVS Pharmacy LLC
• Georgia CVS Pharmacy, L.L.C.
• Georgia CVS Pharmacy, L.L.C.
• Georgia CVS Pharmacy, L.L.C.
• Georgia CVS Pharmacy, L.L.C.
• Georgia Diagnostic Centers
• Georgia Eye Associates, P.C.
• Georgia Eye Group LLC
• Georgia Family Resources LLC

• All providers in Lawrenceville, GA
• Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.