Active NPI
Georgia CVS Pharmacy LLC
Doing business as CVS Pharmacy 07265
- Pharmacy
- Blairsville, GA
National Provider Identifier
1881797629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 006378
- Legal business name
- GEORGIA CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy 07265
- Practice address
- 40 Highway 515
Blairsville, GA 30512-8531 - Phone
- (706) 745-9601
- NPI assigned
- Sep 7, 2006
- Last updated
- Jan 18, 2023
- 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 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 | 006378 | GA | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
40 Highway 515
Blairsville, GA 30512-8531
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1128669 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY 07265
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 2
| 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 |
| O20110411000287 | GA | DME Supplier - Pharmacy | 8123161429 | Practice locations: Blairsville, GA |
National Provider Directory
National Provider Directory- Tax ID family
- Georgia 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674000000000",
"number": "1881797629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "PO 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": "40 HIGHWAY 515",
"city": "BLAIRSVILLE",
"state": "GA",
"postal_code": "305128531",
"telephone_number": "706-745-9601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GEORGIA CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"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": "GA",
"license": "006378",
"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": "1128669",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "CVS PHARMACY 07265",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CVS PHARMACY 07265",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Blairsville, GA
- Thomas Dillard Gary, M.D.
- Gastroenterology of Northeast Georgia PC
- Megan Elaine Gentle, DPT
- Georgia Bracing & Medical Supplies Inc
- Georgia Cancer Specialists I PC
- Georgia Mountain Surgical Associates
- Georgia Mountain Surgical Associates PC
- Georgia Mountains Community Services
- Georgia Mountains Community Services
- Georgia Mountains Community Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.