Organization
CVS HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN THERIAULT (PHARMACIST)
(301) 541-2700
Entity
Organization
Contact information
Practice address
3611 BLADENSBURG RD, BRENTWOOD, MD 20722-1809
(301) 227-6667
(301) 277-1897
Mailing address
3611 BLADENSBURG RD, BRENTWOOD, MD 20722-1809
(301) 227-6667
(301) 277-1897
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
23666
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332507500
—
MD
Enumeration date
12/28/2015
Last updated
12/28/2015
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