# MARYLAND CVS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS Pharmacy \#17102
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750324125
- **Authorized official:** SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 10401 MARTIN LUTHER KING JR HWY, BOWIE, MD 20720-4201
- **Practice address phone:** (301) 955-0108
- **Practice address fax:** (301) 955-0108
- **Mailing address:** 1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | P07038 | MD | — |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 11/08/2016