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NPI Code Detail

MEDICARE: CVS MINUTE CLINIC

MEDICARE: CVS MINUTE CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN185101GA

General Provider Information

NPI Number : 1003260324
Entity Type Code : Organization
Provider Name (Legal Business Name) : CVS MINUTE CLINIC
Provider Business Mailing Address
First Line : 563 GREYHAWK WAY
Second Line :
City : FAIRBURN
State : GA
Zip : 30213-4618
Country : US
Telephone Number : 678-577-9287
Fax Number : 770-774-9837
Provider Business Practice Location Address
First Line : 101 LEXINGTON CIR
Second Line :
City : PEACHTREE CITY
State : GA
Zip : 30269-6845
Country : US
Telephone Number : 770-486-1639
Fax Number :
Authorized Official
Title or Position : FNP
Name : MRS. IVY AKUA FENIN
Credential : APRN
Telephone Number : 678-577-9287
Provider Enumeration Date : 04/22/2016
Last Update Date : 04/22/2016

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Directions to “CVS MINUTE CLINIC ” Practice Location

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