MEDICARE: SOUTH CAROLINA CVS PHARMACY LLC

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
1	3336C0003X	Community/Retail Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy	5004218	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4215061	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154424836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH CAROLINA CVS PHARMACY LLC

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:	BOX 1075
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 W MANNING ST
Second Line	:
City	:	CHESNEE
State	:	SC
Zip	:	29323-1538
Country	:	US
Telephone Number	:	864-461-3123
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, PAYER RELATIONS
Name	:	SUSAN COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	02/08/2012

Similar Medicare Providers

1629326665 — AMANDA JOHNSON WHITAKER
Practice Location Address:

109 W MANNING ST
CHESNEE, SC
29323-1538

Practice Phone: 864-461-3123
Practice Fax: 864-703-2943

1275933640 — DR. MICHAEL BLAIR WEST PHARMD
Practice Location Address:

109 W MANNING ST
CHESNEE, SC
29323-1538

Practice Phone: 864-461-3123
Practice Fax: 864-703-2943

1962482067 — MARYANNE M STOEPPLER DO
Practice Location Address:

513 W HARBOUR CREST DR
CHESNEE, SC
29323

Practice Phone: 864-948-5817
Practice Fax:

1861450397 — DR. PETRA K WARREN M.D.
Practice Location Address:

230 S ALABAMA AVE
CHESNEE, SC
29323-1504

Practice Phone: 864-461-4951
Practice Fax: 864-461-4956

1285684910 — SPARTANBURG SCHOOL DISTRICT TWO
Practice Location Address:

3231 OLD FURNACE RD
CHESNEE, SC
29323-9653

Practice Phone: 864-578-0128
Practice Fax: 864-578-8924

1649293937 — JERRY HAROLD REITZEL DMD
Practice Location Address:

3480 CHESNEE HIGHWAY
CHESNEE, SC
29323

Practice Phone: 864-578-9940
Practice Fax: 864-578-0539

Directions to “SOUTH CAROLINA CVS PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.