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Provider Information for 1972795623


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

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NORTH CAROLINA CVS PHARMACY LLC

Other Names:  
Doing Business As: 
CVS PHARMACY # 04183

Organization Subpart: NO

NPI: 1972795623
Last Updated: 2013-07-02
Certification Date:

Details

NameValue
NPI1972795623
Enumeration Date2007-08-16
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: SUSAN F COLBERT
Title: Director, Payer Relations
Phone: 4017702751
Mailing Address 1 CVS DR
BOX 1075-PHARMACY ENROLLMENTS
WOONSOCKET, RI 02895-6146
United States

Phone: 401-765-1500 | Fax:401-770-7108
 
Primary Practice Address 2001 SPARTANBURG HWY
HENDERSONVILLE, NC 28792-5504
United States

Phone: 828-693-7244 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNC0455801
Other (non-Medicare)NC3408970ncpdp
MEDICAIDNC7704712
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
No 3336C0003X - Pharmacy - Community/Retail Pharmacy
Yes 333600000X - Pharmacy