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General NPI Number Information
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NPI Number | 1164824330
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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 | 09/19/2014
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 1370 HIGHWAY 17
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City | LITTLE RIVER
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State | SC
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Zip | 29566-9219
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Country | US
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Telephone | 843-249-7618
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Fax |
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Provider Business Mailing Address
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Address Line | 4758 LIGHTKEEPERS WAY UNIT 23B
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City | LITTLE RIVER
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State | SC
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Zip | 29566-7960
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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 | ELIZABETH KOPEC
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Credential |
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Telephone | 843-735-9153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 38513
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License Number State | SC
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