SOUTH CAROLINA CVS PHARMACY LLC (NPI# 1114020989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114020989 |
| Entity Type | Organization |
| Organization Name | SOUTH CAROLINA CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #03861 |
| Practice Address |
705 Elm St W Hampton SC 29924-3105 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8039434446 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2012-02-08 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | 50004356 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4207951 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #03861 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710590278 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1919 Springfield Parkway, Fort Mill, SD 29715 | 2020-08-25 |
| 1174175038 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 225 Faison Rd, Mount Pleasant, SC 29466 | 2019-07-11 |
| 1134680762 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 40 D Mark Cummings Rd, Hardeeville, SC 29927-4447 | 2019-03-27 |
| 1508347931 | South Carolina Cvs Pharmacy LLC | Pharmacy | 578 International Dr, Myrtle Beach, SC 29579 | 2018-08-23 |
| 1336409846 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 140 Sayebrook Pkwy, Myrtle Beach, SC 29588-6834 | 2012-05-18 |
| 1043509045 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2373 Augusta Highway, Lexington, SC 29072 | 2011-03-31 |
| 1093018228 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 820 N. Main St., Woodruff, SC 29388 | 2010-12-09 |
| 1871767566 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 914 W Georgia Rd., Simpsonville, SC 29680-6214 | 2008-04-15 |
| 1316155823 | South Carolina Cvs Pharmacy LLC | Pharmacy | 5119 Sunset Blvd, Lexington, SC 29072-9155 | 2007-05-18 |
| 1255490314 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8523 Old State Rd, Holly Hill, SC 29059 | 2006-12-06 |
| Street Address |
705 ELM ST W |
| City | HAMPTON |
| State | SC |
| Zip Code | 29924-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750879060 | Kevin Thompson | Pharmacist | 705 Elm St W, Hampton, SC 29924-3105 | 2018-04-23 |
| 1255877874 | Tony Jacobs | Pharmacist | 705 Elm St W, Hampton, SC 29924-3105 | 2017-01-07 |
| 1417350059 | Jessica Marie Favalora | Pharmacist | 705 Elm St W, Hampton, SC 29924-3105 | 2014-09-26 |
| 1962804617 | Nikolas Shaughnessy | Pharmacist | 705 Elm St W, Hampton, SC 29924-3105 | 2014-09-24 |
| 1639504343 | Rachel Hayes | Pharmacist | 705 Elm St W, Hampton, SC 29924-3105 | 2013-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295247526 | Brittany Bernardino | Pharmacist | 1703 Elm Street W, Hampton, SC 29924 | 2017-10-26 |
| 1497278345 | Bryce Alan Stafford | Pharmacist | 1703 Elm Street West, Hampton, SC 29924 | 2017-07-24 |
| 1427486034 | Teresa L Gooding | Pharmacist | 1703 Elm Stree West, Hampton, SC 29924 | 2013-10-16 |
| 1811241672 | Sc Department of Juvenile Justice | Community/Behavioral Health | 230 1st Street East, Suite 7, Hampton, SC 29924 | 2012-11-01 |
| 1164771994 | Katie M Krise | Pharmacist | 705 Elm Street West, Hampton, SC 29924 | 2012-09-07 |
| 1801164587 | Susan R Britt | Specialist | 707 Elm St, Hampton, SC 29924 | 2011-12-08 |
| 1821384728 | John C Wagner | Pharmacist | 1703 Elm St W, Hampton, SC 29924 | 2011-06-20 |
| 1235424367 | Stanley Joseph Sledziona Jr. | Pharmacist | 1703 Elm St. W, Hampton, SC 29924 | 2011-06-16 |
| 1194010348 | Denise A. Pinckney | Pharmacist | 1703 Elm St West, Hampton, SC 29924 | 2011-06-16 |
| 1154430049 | Francis Asbury Mills | Dentist | 202 3rd St. East, Hampton, SC 29924 | 2006-08-30 |
| Find all providers in zip 29924 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851663629 | Davis Drug | Pharmacy | 2100 Executive Dr, Hampton, VA 23666-2402 | 2012-02-08 |
| 1164587762 | Porter Drug Inc | Pharmacy | 621 State Avenue, Hampton, IL 61256 | 2006-12-26 |
| 1538104658 | Hampton Pharmacy Inc | Pharmacy | 339 Highway 321, Hampton, TN 37658-3277 | 2006-06-20 |
| 1225078645 | Publix Super Markets Inc | Pharmacy | 11155 Tara Blvd, Hampton, GA 30228-1672 | 2006-06-07 |
| 1861452377 | Bayview Plaza Pharmacy, Inc. | Pharmacy | 2268 Executive Dr, Hampton, VA 23666-2430 | 2006-03-27 |
| 1861493447 | Hampton Medical Pharmacy | Pharmacy | 344 S Lee, Hampton, AR 71744-0732 | 2005-08-09 |
| 1497286124 | Genoa Pharmacy | Pharmacy | 200 Medical Dr, Suite 289, Hampton, VA 23666-1763 | 2017-03-24 |
| 1396123691 | On-site Rx, Inc | Pharmacy | 2238 Todds Ln, Hampton, VA 23666-3159 | 2015-05-07 |
| 1629115571 | Hampton Pharmacy Inc | Pharmacy | 339 Highway 321, Hampton, TN 37658-3277 | 2007-01-31 |
| 1134146335 | Wal-mart Stores East Lp | Pharmacy | 1900 Cunningham Dr, Hampton, VA 23666-4260 | 2006-07-16 |
| Find all providers in HAMPTON | ||||
Please comment or provide details below to improve the information on SOUTH CAROLINA CVS PHARMACY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.