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Organization
MARYLAND CVS PHARMACY LLC
Active
Organization
MARYLAND CVS PHARMACY LLC
Active
Other names
CVS Pharmacy # 03043
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1500 RITCHIE HWY, ARNOLD, MD 21012-2400
(410) 757-3902
Mailing address
1 CVS DR, BOX 1075 -PHARMACY ENROLLMENT, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0865702 00 RX
—
MD
05
—
0865729 00 DME
—
MD
01
—
2138673
NCPDP
MD
Enumeration date
09/09/2014
Last updated
01/29/2015
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