Active NPI
South Carolina CVS Pharmacy, L.L.C.
Doing business as CVS Pharmacy # 00528
- Pharmacy
- Johns Island, SC
National Provider Identifier
1659506707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- SOUTH CAROLINA CVS PHARMACY, L.L.C.
- Doing business as
- CVS Pharmacy # 00528
- Practice address
- 3575 Maybank Hwy
Suite K
Johns Island, SC 29455-4823 - Phone
- (843) 559-0328
- NPI assigned
- May 19, 2009
- Last updated
- Jan 20, 2012
- 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
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
3575 Maybank Hwy
Suite K
Johns Island, SC 29455-4823
Mailing address
1 CVS Dr
Box-1075 Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other names 1
- CVS Pharmacy # 00528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930034060 | SC | DME Supplier - Pharmacy | 7214130400 | Practice locations: Johns Island, SC |
| O20101021000051 | SC | Part B Supplier - Mass Immunization (Roster Biller Only) | 7214130400 | This NPI is an additional NPI on the enrollment |
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.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2218273 | South Carolina CVS Pharmacy | Certificate of waiver | Mar 25, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #00528 | Immunosuppressive 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|Urological Supplies|Ent… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- South Carolina CVS Pharmacy LLC
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
3575 Maybank Hwy
Ste K
Johns Island, SC 29455
Phone (843) 559-0328
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
- Johns Island, SC
- NPI 1699023416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242691200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1327017600000",
"number": "1659506707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX-1075 PHARMACY ENROLLMENTS",
"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": "3575 MAYBANK HWY",
"address_2": "SUITE K",
"city": "JOHNS ISLAND",
"state": "SC",
"postal_code": "294554823",
"telephone_number": "843-559-0328"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH CAROLINA CVS PHARMACY, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2009-05-19",
"last_updated": "2012-01-20",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"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": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy # 00528",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Johns Island, SC
- Mary Singleton Young, CMA
- Smartcare Operations Group, Inc. (SmartCare Family Medical Centers)
- Natalie Smith
- David Michael Sohns, PHARM. D
- Soulshine Pediatric Therapy
- South Carolina CVS Pharmacy, L.L.C. (CVS Pharmacy # 00529)
- South Carolina Integrative Health Inc. (Johns Island Acupuncture)
- Southern Speech Therapy LLC
- Eugene Spacey, DMD
- Spacey's Tooth Shoppe, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.