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General NPI Number Information
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NPI Number | 1114319811
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Entity Type | Organization
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Legal Business Name | CVS PHARMACY
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 1631 PADDOCK CLUB LN UNIT 108
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City | FORT MILL
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State | SC
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Zip | 29715-5553
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Country | US
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Telephone | 704-544-2092
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Fax |
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Provider Business Mailing Address
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Address Line | 13845 CONLAN CIR
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City | CHARLOTTE
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State | NC
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Zip | 28277-2705
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MS. CAROLYN KLINEFELTER
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Credential |
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Telephone | 803-984-4851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24767
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License Number State | NC
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