Organization
MARYLAND CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 05706
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
7095 BALTIMORE ANNAPOLIS BLVD, GLEN BURNIE, MD 21061-1431
(410) 859-3113
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
P01813
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119469
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
5511844 00 RX
—
MD
05
—
6611133 00 DME
—
MD
Enumeration date
09/07/2006
Last updated
03/22/2012
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