SOUTH CAROLINA CVS PHARMACY LLC (NPI# 1619074119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619074119 |
| Entity Type | Organization |
| Organization Name | SOUTH CAROLINA CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #01194 |
| Practice Address |
4767 Broad St Loris SC 29569 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8437161220 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2012-02-29 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
50008847 | SC | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4226444 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #01194 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710590278 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1919 Springfield Parkway, Fort Mill, SD 29715 | 2020-08-25 |
| 1174175038 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 225 Faison Rd, Mount Pleasant, SC 29466 | 2019-07-11 |
| 1134680762 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 40 D Mark Cummings Rd, Hardeeville, SC 29927-4447 | 2019-03-27 |
| 1508347931 | South Carolina Cvs Pharmacy LLC | Pharmacy | 578 International Dr, Myrtle Beach, SC 29579 | 2018-08-23 |
| 1336409846 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 140 Sayebrook Pkwy, Myrtle Beach, SC 29588-6834 | 2012-05-18 |
| 1043509045 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2373 Augusta Highway, Lexington, SC 29072 | 2011-03-31 |
| 1093018228 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 820 N. Main St., Woodruff, SC 29388 | 2010-12-09 |
| 1871767566 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 914 W Georgia Rd., Simpsonville, SC 29680-6214 | 2008-04-15 |
| 1316155823 | South Carolina Cvs Pharmacy LLC | Pharmacy | 5119 Sunset Blvd, Lexington, SC 29072-9155 | 2007-05-18 |
| 1255490314 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8523 Old State Rd, Holly Hill, SC 29059 | 2006-12-06 |
| Street Address |
4767 BROAD ST |
| City | LORIS |
| State | SC |
| Zip Code | 29569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497201578 | Mckenzie Nicole Cox | Pharmacist | 4767 Broad St, Loris, SC 29569-2425 | 2016-08-29 |
| 1336497957 | Tiffany Dee Strickland | Pharmacist | 4767 Broad St, Loris, SC 29569-2425 | 2012-08-29 |
| 1205185873 | Brandy Causey | Pharmacist | 4767 Broad St, Loris, SC 29569-2425 | 2012-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427464247 | Denise Logan | Dietitian, Registered | 3811 Walnut St, Loris, SC 29569 | 2014-07-02 |
| 1801231634 | Melissa Ann Miara | Internal Medicine | 3617 Casey St Ste C, Loris, SC 29569 | 2013-05-07 |
| 1356684161 | Gwyn Gordon Mcgutchen | Dentist | 3681 Spivey St., Loris, SC 29569 | 2013-03-29 |
| 1336486174 | Winferd Dale Holt | Dentist | 3980 Main Street, Loris, SC 29569 | 2013-01-14 |
| 1528314325 | Southern Living Emergency Physicians LLC | Physician Assistant | 6988 Mitchell Street, Loris, SC 29569 | 2012-07-30 |
| 1124347604 | Regina F. Holmes | Nurse Practitioner | Agape Senior Primary Care Inc Dba Main Street Physician, 3612 Mitchell Street, Loris, SC 29569 | 2010-05-24 |
| 1801914122 | Dr Gwyn Gordon Mccutchen Inc | Dentist | 3681 Spivey Street, Loris, SC 29569 | 2007-03-26 |
| 1700911203 | Twin States Helping Hands | Home Health | 1620 Hwy 701 N, Loris, SC 29569 | 2007-02-23 |
| 1306922646 | Loris Community Hospital District | Clinic/Center | 3204 Casey St, Loris, SC 29569 | 2006-10-30 |
| 1982642880 | Gary J Barrett Md Pa | Internal Medicine | 3109 Casey St, Loris, SC 29569 | 2006-06-03 |
| Find all providers in zip 29569 | ||||
| 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 |
|---|---|---|---|---|
| 1588761423 | Powers Pharmacy of Loris Inc | Pharmacy | 3985 Meeting St, Loris, SC 29569-3053 | 2006-09-20 |
| 1700881943 | Loris Drug Store, Inc. | Pharmacy | 4125 Main St, Loris, SC 29569-3023 | 2005-06-15 |
| 1831189679 | Gateway Drug Store, Inc. | Pharmacy | 3997 Meeting St, Loris, SC 29569-3053 | 2005-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144840026 | Salubrius Pharmacy, LLC | Pharmacy | 120 Clair Dr, Powdersville, SC 29673-7771 | 2020-04-21 |
| 1073146502 | Greenville Health Corporation | Pharmacy | 115 N Sumter St Ste 220, Sumter, SC 29150-4972 | 2020-02-12 |
| 1043858996 | M Holdings LLC | Pharmacy | 808 Highway 378 Ste A, Lexington, SC 29072-8379 | 2019-12-11 |
| 1033760483 | Eau Claire Cooperative Health Center, Inc. | Pharmacy | 3041 Old Eastover Rd, Eastover, SC 29044-8303 | 2019-09-26 |
| 1467002816 | Black River Pharmacy LLC | Pharmacy | 32a N Williamsburg County Hwy, Kingstree, SC 29556-2433 | 2019-09-18 |
| 1548821457 | Dipti H Patel | Pharmacy | 636 Chartwell Dr, Greer, SC 29650-4787 | 2019-06-23 |
| 1972163350 | Genesis Health Care, Inc | Pharmacy | 211 S Jones Rd Ste A, Olanta, SC 29114-9705 | 2019-06-18 |
| 1013571314 | Publix Super Markets, Inc. | Pharmacy | 730 Hopewell Drive, Charleston-berkeley, SC 29492-7102 | 2019-04-23 |
| 1548769219 | Long's Drugstores of South Carolina, Inc. | Pharmacy | 811 Pendleton St Ste 10, Greenville, SC 29601-3232 | 2018-02-07 |
| 1740788066 | Zivitski Health Group LLC | Pharmacy | 345 W Main Street, Gray Court, SC 29645 | 2018-02-01 |
| 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.