South Carolina CVS Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

5004235 Issued in SC

Legal business name

SOUTH CAROLINA CVS PHARMACY LLC

Doing business as

CVS Pharmacy #03844

Practice address

599 Rice Ave
Union, SC 29379-1840

Phone

(864) 427-7668

NPI assigned

Sep 7, 2006

Last updated

Feb 8, 2012By the provider in NPPES

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 #03844 Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Member of 1

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

• CVS Pharmacy Inc.

  dba CVS Pharmacy #17247

  • Pharmacy
  • North Dartmouth, MA
  • NPI 1831271071

  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": "1497858260",
    "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": "599 RICE AVE",
            "city": "UNION",
            "state": "SC",
            "postal_code": "293791840",
            "telephone_number": "864-427-7668"
        }
    ],
    "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": "5004235",
            "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": "4201997",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #03844",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Sims, MSW, LMSW
• Barbara E Smith, MA, NCC
• Jessia Irene Smith
• Kristen Michelle Smith, RN
• Veronica Smith, RN, MSN,ARNP
• Spartanburg Medical Center (Medical Group of the Carolinas - Hematology Oncology - Union)
• Spartanburg Medical Center (Medical Group of the Carolinas - OB/GYN - Union)
• Spartanburg Medical Center (Medical Group of the Carolinas - Pediatrics - Union)
• Spartanburg Medical Center (Medical Group of the Carolinas - Family Medicine Union - Westside)
• Spartanburg Medical Center (Medical Group of the Carolinas - Internal Medicine- Union)

• Pharmacy in Union, SC
• Providers in Union, SC by specialty
• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.