Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 01461
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
15600 COLUMBIA PIKE, BURTONSVILLE, MD 20866-1630
(301) 421-9060
Mailing address
1 CVS DR, PO BOX 1075, 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
P00522
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100787
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3365085 00
—
MD
Enumeration date
09/12/2006
Last updated
11/19/2010
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