Cvs Pharmacy #04760
LBN: Georgia Cvs Pharmacy, L.L.C.
Cvs Pharmacy #04760 is an health care organization with primary practice located at 480 Glynn St N , Fayetteville GA 30214-1192. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Georgia Cvs Pharmacy, L.L.C. can be contacted via phone (770) 461-3431, or through Colbert, Susan via phone (401) 770-2751.
Contact Information
Primary practice address
480 Glynn St N
Fayetteville GA 30214-1192
Phone: (770) 461-3431
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | 005161 | Georgia |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1821191685 |
|---|---|
| LBN Legal business name | Georgia Cvs Pharmacy, L.L.C. |
| DBA Doing business as | Cvs Pharmacy #04760 |
| Authorized official | Colbert, Susan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 7th, 2006 |
| Last updated | Mar 7th, 2012 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821191685 | NPPES |
| Other | 1138975 | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| MEDICAID | 000529691B | OTHER ID NUMBER-COMMERCIAL NUMBER |
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