Provider Type Icon

GEORGIA CVS PHARMACY LLC NPI 1619070455


NPI Information

NPI: 1619070455
Provider Name: GEORGIA CVS PHARMACY LLC

Doing Business As: CVS PHARMACY # 05684

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 11D2281752

Address:
348 W PINE ST
JESUP, GA
ZIP 31545
Phone: (912) 427-8006
Get Directions

GEORGIA CVS PHARMACY LLC is a pharmacy in Jesup, GA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. GEORGIA CVS PHARMACY LLC NPI is 1619070455. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy # 05684.

The provider's business location address is:

348 W PINE ST
JESUP, GA
ZIP 31545-429
Phone: (912) 427-8006

The provider's authorized official is Susan Colbert .
The authorized official title is Director, Payer Relations and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 11D2281752 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 10/24/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacy005698GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11125752OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2000209624AMEDICAIDGEORGIA
35754010286MEDICARE NSC
4202G738984MEDICARE PIN
5P00962782MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.