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NPI Code Detail

MEDICARE: SOUTH CAROLINA CVS PHARMACY, L.L.C.

MEDICARE: SOUTH CAROLINA CVS PHARMACY, L.L.C.
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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24228880OTHERNCPDP

General Provider Information

NPI Number : 1386872604
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH CAROLINA CVS PHARMACY, L.L.C.
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 : 401-735-1080
Provider Business Practice Location Address
First Line : 101 FOUNDERS BAY RD
Second Line :
City : MURRELLS INLET
State : SC
Zip : 29576-8089
Country : US
Telephone Number : 436-518-8638
Fax Number :
Authorized Official
Title or Position : DIRECTOR, PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-765-1500
Provider Enumeration Date : 06/25/2009
Last Update Date : 07/03/2024

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