Provider Information for 1215031158
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GEORGIA CVS PHARMACY, L.L.C.
Other Names:Doing Business As:CVS PHARMACY #03125Organization Subpart: NO
NPI: 1215031158
Last Updated: 2012-03-06
Certification Date:
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Details
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NPI | 1215031158 | ||||||||||||||||
Enumeration Date | 2006-09-12 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: SUSAN F COLBERT Title: Director, Payer Relations Phone: 4017702751 | ||||||||||||||||
Mailing Address | 1 CVS DR PO BOX 1075 WOONSOCKET, RI 02895-6146 United States Phone: | Fax: | ||||||||||||||||
Primary Practice Address | 895 HOLCOMB BRIDGE RD ROSWELL, GA 30076-1954 United States Phone: 770-993-0194 | Fax: | ||||||||||||||||
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