Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 01880
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
12825 WISTERIA DRIVE, GERMANTOWN, MD 20874-2654
(301) 540-1103
Mailing address
1 CVS DR, PO BOX 1090, 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
P01750
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118811
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3521079 00
—
MD
05
—
6632190 00 - DME
—
MD
Enumeration date
09/19/2006
Last updated
12/08/2016
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