CVS PHARMACY # 05628
NPI 1356444194
Pharmacy in Stockbridge, GA

Active since September 07, 2006CLIA 11D2281263 · Waiver
5415 N HENRY BLVD, STOCKBRIDGE, GA 30281(770) 474-1355 Get Directions Write a Review

NPPES record last updated: October 24, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Cvs Pharmacy # 05628 NPPES

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

CVS PHARMACY # 05628 (NPI 1356444194) is a healthcare organization registered as a pharmacy in Stockbridge, Georgia and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists Susan Colbert, Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1356444194
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameGEORGIA CVS PHARMACY LLC
Location Address5415 N HENRY BLVDStockbridge, GA 30281-3222
Mailing Address1 Cvs Dr, Po Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500
Organization SubpartNo
Authorized OfficialSusan ColbertDirector, Payer Relations · (401) 770-2751
Enumeration DateSeptember 7, 2006
Last NPPES UpdateOctober 24, 2011
NPI 1356444194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License Licensed in GA · 005554
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
5415 N HENRY BLVD, Stockbridge, GA 30281

Other Names 1

Doing Business AsCvs Pharmacy # 05628

Other Identifiers 5

Medicaid000192079AGA
Medicare NSC5754010270
Medicare PINP00962782GA
Medicare PIN202G738984
Other1125067Other Id Number-commercial Number

Accepted 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 11D2281263

Georgia CVS Pharmacy, LLC Dba Cvs/Pharmacy #05628 · Stockbridge, GA
Active · expires May 3, 2027
CLIA Number11D2281263
Laboratory TypePharmacy
Certificate Effective DateMay 4, 2025
Certificate Expiration DateMay 3, 2027
Laboratory DirectorPatterson Quenin
Laboratory Phone(770) 474-1355
Laboratory LocationGeorgia CVS Pharmacy, LLC Dba Cvs/Pharmacy #056285415 N Henry Boulevard, Stockbridge, GA 30281
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 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.
64 services64 patients
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage 90694
The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
59 services59 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20325137
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Blood Glucose Monitors/Supplies (Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Enteral Nutrients - Enteral formula
  • Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
  • Parenteral Nutrients - Parenteral nutrient solutions
  • Parenteral Equipment and/or Supplies - Parenteral infusion pumps, parenteral nutrition supply kits
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

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.

Pharmacist
5415 N HENRY BLVD
STOCKBRIDGE, GA 30281
Pharmacist
5415 N HENRY BLVD
STOCKBRIDGE, GA 30281
Pharmacist
5415 N HENRY BLVD
STOCKBRIDGE, GA 30281

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356444194, enumerated as an "organization" on September 07, 2006.

The provider is located at 5415 N HENRY BLVD STOCKBRIDGE, GA 30281 and the phone number is (770) 474-1355.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.