Active NPI
Georgia CVS Pharmacy, L.L.C.
- Pharmacy
- Newnan, GA
National Provider Identifier
1720122880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- GEORGIA CVS PHARMACY, L.L.C.
- Practice address
- 1035 Lower Fayetteville Rd
Newnan, GA 30265-1132 - Phone
- (678) 423-8891
- NPI assigned
- Feb 20, 2007
- 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 | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1035 Lower Fayetteville Rd
Newnan, GA 30265-1132
Mailing address
1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other names 1
- CVS Pharmacy # 00962
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100209000543 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8123161429 | 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 |
|---|---|---|---|
| 11D2282915 | Georgia CVS Pharmacy, LLC | Certificate of waiver | May 29, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
1035 Lower Fayetteville Rd
Newnan, GA 30265
Phone (678) 423-8891
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Newnan, GA
- NPI 1003649898
-
- Pharmacist
- Newnan, GA
- NPI 1194447268
-
- Pharmacist
- Newnan, GA
- NPI 1124623012
-
- Pharmacist
- Newnan, GA
- NPI 1902494180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761091200000",
"number": "1720122880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 LOWER FAYETTEVILLE RD",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302651132",
"telephone_number": "678-423-8891"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GEORGIA CVS PHARMACY, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-20",
"last_updated": "2025-10-22",
"certification_date": "2025-10-22",
"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": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy # 00962",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Newnan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.