Georgia Cvs Pharmacy LLC

NPI #1619070463 in Ellenwood, Georgia

Provider Information

NPI Number: 1619070463
Entity Type: Organization
Organization Name: Georgia Cvs Pharmacy LLC
Primary Specialty: Pharmacy
Enumeration Date: Sep 7, 2006
Last Updated: Sep 8, 2011

Practice Location

Address: 80 FAIRVIEW RD
City: Ellenwood
State: Georgia
ZIP Code: 30294-2767
Phone: (770) 808-8204

Authorized Official

Name: SUSAN COLBERT
Title: DIRECTOR, PAYER RELATIONS
Phone: (401) 770-2751

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy	3336C0003X
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy	333600000X	Primary

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