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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	5004323	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4200907	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1841393600
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	:	315 W BUTLER RD
Second Line	:
City	:	MAULDIN
State	:	SC
Zip	:	29662-2531
Country	:	US
Telephone Number	:	864-288-1847
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	:	12/06/2011

Similar Medicare Providers

1922078252 — MS. SANDRA ANN OLSON NP
Practice Location Address:

309 WEST BUTLER ROAD
MAULDIN, SC
29662-2531

Practice Phone: 864-297-1575
Practice Fax: 864-297-6256

1093775397 — DR. MARIE ROSE BONABON M.D.
Practice Location Address:

309 W BUTLER RD
MAULDIN, SC
29662-2531

Practice Phone: 864-297-1575
Practice Fax: 864-284-0844

1679593909 — DR. BIJAL DESAI M.D.
Practice Location Address:

309 W BUTLER RD
MAULDIN, SC
29662-2531

Practice Phone: 864-297-1575
Practice Fax: 877-817-1801

1386920502 — LESLEY D LOOPER PA
Practice Location Address:

309 W BUTLER RD
MAULDIN, SC
29662-2531

Practice Phone: 864-297-1575
Practice Fax: 864-297-6256

1023366655 — DR. CHRISTINA KIMBALL PHARMD
Practice Location Address:

315 W BUTLER RD
MAULDIN, SC
29662-2531

Practice Phone: 864-288-1847
Practice Fax:

1649611518 — DR. ANGELA ROSE PEIGHTAL PHARMD
Practice Location Address:

315 W BUTLER RD
MAULDIN, SC
29662-2531

Practice Phone: 864-288-1847
Practice Fax:

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.