CVS PHARMACY # 03777 – Pharmacy, NPI 1861595522

CVS PHARMACY # 03777 is a healthcare provider. based in Monroe, Georgia. specializing in Pharmacy. The organization holds a License No. 004454 (GA). The NPI Number for CVS PHARMACY # 03777 is 1861595522

Main info

Organization
Name
CVS PHARMACY # 03777
NPI
1861595522
Phone
(770) 267-8412
Address
312 S BROAD ST
Authorized Official
SUSAN F COLBERT EXEC DIR, RX SERVICES
Enumeration Date
7 September 2006
Last Update Date
12 January 2023

Contacts

Main Contact
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness90
Years active:19State licenses:1Updated within 12 months

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Provider Addresses for CVS PHARMACY # 03777

  • 312, South Broad Street, Monroe, Walton County, Georgia, 30655, United States

    MONROE, GA 306552106

    Phone: (770) 267-8412

    Type: Location

  • CVS Caremark Corporation, 1, CVS Drive, Woonsocket, Providence County, Rhode Island, 02895, United States

    PO BOX 1075

    WOONSOCKET, RI 028956146

    Phone: (401) 765-1500

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-05-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-05-31 (11 days ago).

Enrollment records

1

Earliest due date

2026-05-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20110505000746OPharmacyGA2026-05-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count68380$0
G0008Administration of influenza virus vaccine265264$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage199199$0
91320Sarscv2 vac 30mcg trs-suc im140140$0
90480Admn sarscov2 vacc 1 dose140140$0
View full utilization report →

Insurance plans in this area (ZIP 30655)

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Reviews

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Frequently asked questions

Can I verify CVS PHARMACY # 03777 with an NPI only?
You can start verification with NPI 1861595522 for CVS PHARMACY # 03777, then check state licensing separately.
Is CVS PHARMACY # 03777 listed as active for patients and plans?
The listing shows CVS PHARMACY # 03777 as active in the NPI system.
What is CVS PHARMACY # 03777 best known for clinically?
Directory data describes CVS PHARMACY # 03777 with Pharmacy. Clinical services aligned with this taxonomy classification.
What area does CVS PHARMACY # 03777 serve?
CVS PHARMACY # 03777's listing highlights Monroe, Georgia; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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