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Organization

CVS

Active
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Organization

CVS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER REZAKHAN (DISTRICT MANAGER)
(443) 716-5153
Entity
Organization

Contact information

Practice address
6480 OLD WATERLOO ROAD, ELKRIDGE, MD 21075
(410) 799-0291
Mailing address
8839 STONEBROOK LN, COLUMBIA, MD 21046-1415
(919) 449-6230

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
23561
MD

Other

Enumeration date
09/01/2015
Last updated
09/01/2015
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