North Carolina CVS Pharmacy LLC
Organization Active NPI Pharmacy · Oak Ridge, NC
NPI 1811095466 · NPPES record last updated Jul 12, 2013
Key facts
- NPI
- 1811095466
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 8501 (NC)
- Legal business name
- NORTH CAROLINA CVS PHARMACY LLC
- Practice address
- 2300 Hwy 150
Oak Ridge, NC 27310 - Phone
- (336) 644-6384
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan F Colbert
- Title
- Director, Managed Care Admin
- Phone
- (401) 770-2751
Corporate family (same tax ID) 24
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080116000795 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 9133200017 | This NPI is an additional NPI on the enrollment |
| O20100930060306 | NC | DME Supplier - Pharmacy | 9133200017 | Practice locations: Oak Ridge, NC |
National Provider Directory
- Tax ID family
- North Carolina CVS Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 8501 | NC | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
2300 Hwy 150
Oak Ridge, NC 27310
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3441881 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- CVS PHARMACY #06033
Other providers in Oak Ridge, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.