Tennessee Cvs Pharmacy LLC
Pharmacy in Tullahoma, TN. Organization (NPI-2).
NPI number1619070331
StatusActive
Last updated in NPPESJan 31, 2021
Details
- NPI
- 1619070331
- Entity type
- Organization (NPI-2)
- Legal business name
- Tennessee Cvs Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- Sep 7, 2006
- Certification date
- Jan 28, 2021
- Last updated
- Jan 31, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · DME SUPPLIER - PHARMACY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 1171 | TN | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Cvs Pharmacy #04466 (Doing Business As)
Practice location
1351 N Jackson StTullahoma, TN 37388-2339
Phone 931-455-9362
Mailing address
1 Cvs DrPo Box 1075
Woonsocket, RI 02895-6146
Phone 401-765-1500
Authorized official
Susan F Colbert
Director, Payer Relations
4017702751
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Other Pharmacy providers in Tullahoma, TN
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