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General NPI Number Information
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NPI Number | 1114166287
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Entity Type | Organization
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Legal Business Name | CARECENTER PHARMACY, L.L.C.
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 2455 PACES FERRY RD, NW SSC BLDGC, FLR 2
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City | ATLANTA
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State | GA
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Zip | 30339-1834
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Country | US
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Telephone | 401-765-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CVS DR BOX 1075 - PHARMACY ENROLLMENTS
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City | WOONSOCKET
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State | RI
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Zip | 02895-6146
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Country | US
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Telephone | 401-765-1500
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Fax | 401-770-7108
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Authorized Official
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Title or Position | DIRECTOR, PAYER RELATIONS
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Name | SUSAN COLBERT
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Credential |
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Telephone | 401-765-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State | GA
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