# MARYLAND CVS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS PHARMACY 01795
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629175112
- **Authorized official:** SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 5100 BROWN STATION RD, UPPER MARLBORO, MD 20772-9132
- **Practice address phone:** (301) 627-1500
- **Mailing address:** 1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500
- **Mailing address fax:** (401) 770-7108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | P01596 | MD | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/19/2006
- **Last updated:** 03/23/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2117340 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | 570060400 - RX | — | MD |