GEORGIA CVS PHARMACY, L.L.C. (NPI# 1821191685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821191685 |
| Entity Type | Organization |
| Organization Name | GEORGIA CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #04760 |
| Practice Address |
480 Glynn St N Fayetteville GA 30214-1192 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7704613431 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2012-03-07 |
| 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 |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | 005161 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1138975 | 01 | |
| GA | 000529691B | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #04760 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699095869 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1800 Brunswick Hwy, Waycross, GA 31501-1061 | 2010-06-10 |
| 1245550417 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 680 Ponce De Leon Ave., Atlanta, GA 30308-1808 | 2010-06-10 |
| 1861711947 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 5101 Washington Rd, Evans, GA 30809-6445 | 2010-05-27 |
| 1427388453 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 965 Joe Frank Harris Pkwy Se, Cartersville, GA 30120-2130 | 2010-01-14 |
| 1518296318 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1162 West Ave., Cartersville, GA 30120-6138 | 2009-12-08 |
| 1689807018 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 7355 Roswell Rd Ne, Sandy Springs, GA 30328-1044 | 2009-09-02 |
| 1801022918 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 795 Oglethorpe Ave., Athens, GA 30606-2242 | 2009-06-03 |
| 1912131335 | Georgia Cvs Pharmacy, L.L.C. | Pharmacy | 5384 Highway 20 S, Covington, GA 30016-4403 | 2009-05-13 |
| 1568605400 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 3221 Peachtree Road Ne, Atlanta, GA 30305-2414 | 2009-04-08 |
| 1508004169 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1905 Martha Berry Blvd., Rome, GA 30165-1649 | 2009-02-04 |
| Street Address |
480 GLYNN ST N |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-1192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598205270 | Pamela Kelley | Nurse Practitioner | 480 Glynn St N, Fayetteville, GA 30214-1192 | 2017-03-01 |
| 1629262936 | Virginia Wilson | Nurse Practitioner | 480 Glynn St N, Fayetteville, GA 30214-1192 | 2007-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| 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 |
|---|---|---|---|---|
| 1548767619 | Atlanta Id Group, P.C. | Pharmacy | 1265 Highway 54 West, Suite 500-c, Fayetteville, GA 30214 | 2018-04-06 |
| 1760924088 | Clear Med Solutions LLC | Pharmacy | 1450 E Zion Rd Ste 3, Fayetteville, AR 72703-4988 | 2016-11-17 |
| 1386005148 | New River Health Association, Inc | Pharmacy | 217 W Maple Ave, Fayetteville, WV 25840-1413 | 2016-03-08 |
| 1417336686 | Valley Discount Pharmacy Incorporated | Pharmacy | 317 Owen Dr, Fayetteville, NC 28304-3429 | 2015-05-21 |
| 1780973693 | Walmart Inc. | Pharmacy | 3475 Black Forest Dr, Fayetteville, AR 72704-6524 | 2011-03-31 |
| 1417182296 | Cumberland County Hospital System Inc | Pharmacy | 101 Robeson St Ste 107, Fayetteville, NC 28301-5520 | 2009-05-21 |
| 1326183922 | Carolina Family Pharmacy,inc | Pharmacy | 2800 Raeford Rd Ste 18, Suite 18, Fayetteville, NC 28303-5465 | 2007-02-21 |
| 1730248733 | Carolina Family Pharmacy Inc | Pharmacy | 2800 18 Raeford Rd, Fayetteville, NC 28303 | 2006-12-06 |
| 1548328677 | Carters At Stone Bridge LLC | Pharmacy | 6 Eldad Rd, Fayetteville, TN 37334-7005 | 2006-12-04 |
| 1568537140 | Zimm Pharmacy Inc | Pharmacy | 239 N Court St, Fayetteville, WV 25840-1233 | 2006-11-21 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on GEORGIA CVS PHARMACY, L.L.C..
| 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.