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Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY 01491
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
8859 BRANCH AVE, CLINTON, MD 20735-2632
(301) 868-4055
Mailing address
1 CVS DR, PO BOX 1075, 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
P00548
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100989
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3620051 00
—
MD
01
—
P00754558
MEDICARE RR
MD
01
—
P00754558
RAIL ROAD PIN
—
Enumeration date
09/12/2006
Last updated
11/19/2010
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