NPIMap

Organization Active NPI

North Carolina CVS Pharmacy LLC

Doing business as CVS Pharmacy #01643

  • Pharmacy
  • Davidson, NC
National Provider Identifier
1750464798
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
NORTH CAROLINA CVS PHARMACY LLC
Doing business as
CVS Pharmacy #01643
Practice address
2002 Shiloah Church Rd
Davidson, NC 28036
Phone
(704) 439-3461
NPI assigned
Oct 23, 2006
Last updated
May 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X 09414 NC

Addresses

Primary practice location

2002 Shiloah Church Rd
Davidson, NC 28036

Mailing address

2002 Shiloah Church Rd
Davidson, NC 28036
Phone (401) 765-1500

Other names 1

  • CVS PHARMACY #01643 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080116000795 NC Part B Supplier - Mass Immunization (Roster Biller Only) 9133200017 This NPI is an additional NPI on the enrollment
O20100930011279 NC DME Supplier - Pharmacy 9133200017 Practice locations: Davidson, NC

National Provider Directory

National Provider Directory
Tax ID family
CVS324 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.

View all 24

Member of 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1750464798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 SHILOAH CHURCH RD",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "28036",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 SHILOAH CHURCH RD",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "28036",
            "telephone_number": "704-439-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-05-17",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "09414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #01643",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davidson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.