# MARYLAND CVS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS Pharmacy \# 03517
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952696197
- **Authorized official:** SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 825 WAYNE AVE, SILVER SPRING, MD 20910-4427
- **Practice address phone:** (301) 562-5414
- **Mailing address:** 1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, 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 | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/16/2011
- **Last updated:** 02/01/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2135855 | NCPDP | MD |
| 05 | — | 2202051 00 | — | MD |
| 05 | — | 5560080 00 | — | MD |