1. Home
  2. Directory
  3. South Carolina
  4. Summerville
  5. Pharmacy
  6. NPI Profile

CVS PHARMACY #04395
NPI 1154424828
Pharmacy in Summerville, SC

Active since September 07, 2006CLIA Certified · 2 labs
10599 DORCHESTER RD, SUMMERVILLE, SC 29485(843) 871-7701(843) 875-9242 Get Directions Write a Review

NPPES record last updated: February 8, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cvs Pharmacy #04395 NPPES

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

CVS PHARMACY #04395 (NPI 1154424828) is a healthcare organization registered as a pharmacy in Summerville, South Carolina and active in the NPI registry since September 2006. The organization holds 2 active CLIA laboratory certificates and lists Susan Colbert, Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1154424828
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameSOUTH CAROLINA CVS PHARMACY LLC
Location Address10599 DORCHESTER RDSummerville, SC 29485-8047
Mailing Address1 Cvs Dr, Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500
Phone(843) 871-7701
Fax(843) 875-9242
Organization SubpartNo
Authorized OfficialSusan ColbertDirector, Payer Relations · (401) 770-2751
Enumeration DateSeptember 7, 2006
Last NPPES UpdateFebruary 8, 2012
✔ NPI 1154424828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in SC · 50004370
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
10599 DORCHESTER RD, Summerville, SC 29485
Open in Google Maps ↗

Other Names 1

Doing Business AsCvs Pharmacy #04395

Other Identifiers 4

Medicare PINQ356270001
Medicare NSC5765980070
Medicare PINP00986712
Other4209741Other Id Number-commercial Number

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 2

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 42D2227511

South Carolina CVS Pharmacy, LLC Dba Cvs/Pharmacy #04395 · Summerville, SC
Active · expires Jun 13, 2027
CLIA Number42D2227511
Laboratory TypePharmacy
Certificate Effective DateJune 14, 2025
Certificate Expiration DateJune 13, 2027
Laboratory DirectorJessica Kirklaand
Laboratory Phone(866) 389-2727
Laboratory LocationSouth Carolina CVS Pharmacy, LLC Dba Cvs/Pharmacy #0439510599 Dorchester Rd, Summerville, SC 29485
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 42D2225775

South Carolina CVS Pharmacy, LLC Dba Cvspharmacy #00563 · Summerville, SC
Active · expires May 23, 2027
CLIA Number42D2225775
Laboratory TypePharmacy
Certificate Effective DateMay 24, 2025
Certificate Expiration DateMay 23, 2027
Laboratory DirectorLinda Zheng
Laboratory Phone(866) 389-2727
Laboratory LocationSouth Carolina CVS Pharmacy, LLC Dba Cvspharmacy #005631515 Old Trolley Rd, Summerville, SC 29485
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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.
144 services141 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.
108 services108 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.
24 services24 patients

Medical Equipment Supplier Medicare DMEPOS 18

Medicare supplier enrollment and the product categories CVS Pharmacy #04395 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #04395

DMEPOS supplier · Summerville, SCOperated by South Carolina CVS Pharmacy LLC
⋮

Does not accept Medicare assignment

CVS Pharmacy #04395 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)20429165
Medicare Participant SinceJanuary 1, 2019
Supplier Location10599 Dorchester RdSummerville, SC 29485
Phone(843) 871-7701
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 3

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

ELISSA ROSE SHERIDAN PHARMD
Pharmacist
10599 DORCHESTER RD
SUMMERVILLE, SC 29485
Dorchester County (843) 871-7701
COREY W BOILS
Pharmacist
10599 DORCHESTER RD
SUMMERVILLE, SC 29485
Dorchester County (843) 871-7701
REBECCA HOONE PHARM D
Pharmacist
10599 DORCHESTER RD
SUMMERVILLE, SC 29485
Dorchester County (843) 871-7701

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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

The NPI number for South Carolina CVS Pharmacy LLC is 1154424828. It was assigned to this organization in the NPPES registry on September 7, 2006. The provider is doing business as CVS Pharmacy #04395.

Where is South Carolina CVS Pharmacy LLC located?

South Carolina CVS Pharmacy LLC is located at 10599 Dorchester Rd, Summerville, SC 29485. The listed phone number is (843) 871-7701.

What is South Carolina CVS Pharmacy LLC's specialty?

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

Does South Carolina CVS Pharmacy LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, CVS Pharmacy #04395 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does South Carolina CVS Pharmacy LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does South Carolina CVS Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 33 other insurers list South Carolina CVS Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Carolina CVS Pharmacy LLC was last updated on February 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.