Tennessee CVS Pharmacy LLC
NPI 1104929801ActiveOrganization· Pharmacy· Cleveland, TN
Pharmacy in Cleveland, Tennessee, registered in NPPES in September 2006. The authorized official on file is Susan F. Colbert, Director, Payer Relations. Medicare paid $74,147 for services to 317 patients in 2024.
Overview
| NPI | 1104929801 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 7, 2006 |
| Last updated in NPPES | Sep 16, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 0000000050 | TN |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (TN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 317 |
|---|---|
| Services billed | 958 across 10 procedure codes |
| Paid by Medicare | $74,147 |
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