CVS PHARMACY #03809
NPI 1023111887
Pharmacy in Rock Hill, SC

Q: What is South Carolina CVS Pharmacy LLC's NPI number?

The NPI number for South Carolina CVS Pharmacy LLC is 1023111887. It was assigned to this organization in the NPPES registry on September 7, 2006.

Q: What is South Carolina CVS Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Active since September 07, 2006CLIA 42D2285098 · Waiver

609 CHERRY RD, ROCK HILL, SC 29732(803) 328-6111 Get Directions Write a Review

NPPES record last updated: March 1, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Cvs Pharmacy #03809 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #03809 (NPI 1023111887) is a healthcare organization registered as a pharmacy in Rock Hill, South Carolina and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through July 5, 2027 and lists Susan Colbert, Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1023111887

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameSOUTH CAROLINA CVS PHARMACY LLC

Location Address609 CHERRY RDRock Hill, SC 29732-3119

Mailing Address1 Cvs Dr, Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500

Phone(803) 328-6111

Organization SubpartNo

Authorized OfficialSusan ColbertDirector, Payer Relations · (401) 770-2751

Enumeration DateSeptember 7, 2006

Last NPPES UpdateMarch 1, 2012

✔ NPI 1023111887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in SC · 50004187

Definition

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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X

609 CHERRY RD, Rock Hill, SC 29732

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Other Names 1

Doing Business AsCvs Pharmacy #03809

Other Identifiers 4

Other4200820Other Id Number-commercial Number

Medicare PINQ356270001SC

Medicare NSC5765980122

Medicare PINP00986712

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2285098

South Carolina CVS Pharmacy, LLC Dba Cvspharmacy #03809 · Rock Hill, SC

Active · expires Jul 5, 2027

CLIA Number42D2285098

Laboratory TypePharmacist

Certificate Effective DateJuly 6, 2025

Certificate Expiration DateJuly 5, 2027

Laboratory DirectorBarron Foster

Laboratory Phone(803) 328-6111

Laboratory LocationSouth Carolina CVS Pharmacy, LLC Dba Cvspharmacy #03809609 Cherry Road, Rock Hill, SC 29732

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

239 services237 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

209 services208 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

39 services39 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

39 services39 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

12 services12 patients

Medical Equipment Supplier Medicare DMEPOS 18

Medicare supplier enrollment and the product categories CVS Pharmacy #03809 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #03809

DMEPOS supplier · Rock Hill, SCOperated by South Carolina CVS Pharmacy LLC

⋮

Does not accept Medicare assignment

CVS Pharmacy #03809 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20429543

Medicare Participant SinceJanuary 1, 2019

Supplier Location609 Cherry RdRock Hill, SC 29732

Phone(803) 328-6111

Supplier Specialties

Pharmacy

Medicare Product Categories

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Commodes, Urinals, Bedpans

Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JOHN AMOS ARANT JOHN ARANT

Pharmacist