GEORGIA CVS PHARMACY LLC (NPI# 1316969108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316969108 |
| Entity Type | Organization |
| Organization Name | GEORGIA CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #16729 |
| Practice Address |
4241 Lavista Rd Tucker GA 30084-5310 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7709343563 |
| Practice Fax Number | 7709343563 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-10-12 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE010216 | GA | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2014391 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16729 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548504343 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 441 Fair Rd, Statesboro, GA 30458-4913 | 2012-11-16 |
| 1528302403 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1520 Avenue Pl, Suite B-100, Atlanta, GA 30329-4015 | 2012-11-16 |
| 1710232913 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5900 Watson Blvd, Warner Robins, GA 31093-8669 | 2012-07-13 |
| 1811256605 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3674 Highway 5, Douglasville, GA 30135-2364 | 2012-05-14 |
| 1447528039 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1680 Old Pendergrass Rd, Jefferson, GA 30549-2701 | 2011-12-09 |
| 1437458593 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3595 Atlanta Hwy, Athens, GA 30606-3152 | 2011-03-15 |
| 1174771521 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5570 Roswell Rd, Sandy Springs, GA 30342-1861 | 2008-08-28 |
| 1083875173 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 13055 Highway 9 N, Milton, GA 30004-5137 | 2008-06-20 |
| 1881870806 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5865 Spout Springs Rd, Flowery Branch, GA 30542-3448 | 2008-01-22 |
| 1033303961 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5950 State Bridge Rd, Duluth, GA 30097-6438 | 2007-09-04 |
| Street Address |
4241 LAVISTA RD |
| City | TUCKER |
| State | GA |
| Zip Code | 30084-5310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437527256 | Connolly Anne Pigott | Pharmacist | 4241 Lavista Rd, Tucker, GA 30084-5310 | 2015-09-10 |
| 1184029670 | Tara Hall | Pharmacist | 4241 Lavista Rd, Tucker, GA 30084-5310 | 2014-10-27 |
| 1538505763 | Stacie Cooper | Pharmacist | 4241 Lavista Rd, Tucker, GA 30084-5310 | 2013-05-15 |
| 1982981346 | Saba Karamali | Pharmacist | 4241 Lavista Rd, T-1390, Tucker, GA 30084-5310 | 2011-11-12 |
| 1205117397 | Kiel James Muserallo | Pharmacist | 4241 Lavista Rd, Tucker, GA 30084-5310 | 2011-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609401355 | Excellent Medical Transport | Ambulance | 4378 Sentry Dr, Tucker, GA 30084 | 2020-03-03 |
| 1811468796 | Caleb Lee Ebbets | Physical Therapist | 1459 Montreal Road, Medical Office Building, Suite 301, Tucker, GA 30084 | 2018-12-17 |
| 1417436130 | Benjamin Han Wook Chong | Physical Therapist | 1460 Montreal Road East, Suite 300, Tucker, GA 30084 | 2018-08-13 |
| 1336659325 | Lavista Acupuncture and Herbal Medicine | Acupuncturist | 4915 Lavista Rd, Tucker, GA 30084 | 2017-10-04 |
| 1699294207 | Debrica Butler | Counselor | 1021 Oak Chase Dr., Apt C, Tucker, GA 30084 | 2017-09-14 |
| 1295264695 | Jolanta Wazgowska Hopkins | Social Worker | 4404 Idlewood Lane, Tucker, GA 30084 | 2017-06-08 |
| 1164956157 | Sage Dental Group of Georgia LLC | Dentist | 4320 Lavista Rd, Suite C119, Tucker, GA 30084 | 2017-04-17 |
| 1689107807 | Mashail Manzur | Podiatrist | 1460 Montreal Rd E, Ste 275, Tucker, GA 30084 | 2017-04-05 |
| 1053765578 | Jessica Spruyt | Speech-Language Pathologist | 3756 Lavista Rd Suite 104, Tucker, GA 30084 | 2016-04-21 |
| 1265802318 | Spine and Orthopedics of Atlanta, LLC | Clinic/Center | 1462 Montreal Rd Ste 218, Tucker, GA 30084 | 2015-10-01 |
| Find all providers in zip 30084 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851420632 | Carrs Pharmacy Inc | Pharmacy | 2340 Main St, Tucker, GA 30084-4413 | 2007-03-05 |
| 1205872686 | Kaiser Permanente Internal | Pharmacy | 200 Cres Ctr Pkwy, Tucker, GA 30084-7047 | 2006-06-22 |
| 1316223514 | Una Pharmacy | Pharmacy | 1462 Montreal Rd, Ste 101, Tucker, GA 30084-6929 | 2011-11-01 |
| 1548206931 | Glory Pharmacy Inc | Pharmacy | 1462 Montreal Rd, Tucker, GA 30084-6904 | 2006-06-22 |
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|---|---|---|---|---|
| 1922607662 | H & W Pharmacy | Pharmacy | 4091 Redan Rd Ste C, Stone Mountain, GA 30083-4767 | 2020-10-23 |
| 1720603756 | Medical-pharmacy Associates of Georgia, LLC | Pharmacy | 1425 Georgia Ave Ste 1, Macon, GA 31201-6546 | 2020-06-16 |
| 1700419454 | Janus Rx | Pharmacy | 836 E 65th St Ste 42, Savannah, GA 31405-4496 | 2020-02-20 |
| 1295373702 | Downtown Pharmacy LLC | Pharmacy | 236 Forsyth St Sw Ste 202b, Atlanta, GA 30303-3786 | 2019-12-16 |
| 1750928719 | Goodscript, Inc. | Pharmacy | 3115 Roswell Rd Ste 205, Marietta, GA 30062-7611 | 2019-12-09 |
| 1942844741 | Genoa Healthcare, LLC | Pharmacy | 400 Technology Ct Se Ste J, Room P, Smyrna, GA 30082-5237 | 2019-11-05 |
| 1225670995 | Allcare Pharmacy, LLC | Pharmacy | 1004 S Tennille Ave, Donalsonville, GA 39845 | 2019-10-14 |
| 1417598327 | Connect Care Pharmacy, LLC | Pharmacy | 2191 Hwy 247 Connector, Byron, GA 31008-5531 | 2019-10-02 |
| 1467003467 | Selamawit Dejene | Pharmacy | 464 Bishop St Nw Apt 336, Atlanta, GA 30318-5384 | 2019-09-23 |
| 1902454721 | Batts Drug Company Mansfield, LLC | Pharmacy | 4424 Highway 213, Mansfield, GA 30055-3211 | 2019-08-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.