Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy #01177
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
11190 VIERS MILL ROAD, WHEATON, MD 20902
(301) 942-1791
(401) 770-7108
Mailing address
1 CVS DRIVE, BOX 1075-PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-7243
(401) 766-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
P04473
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6611079 00
—
MD
Enumeration date
10/05/2006
Last updated
11/10/2010
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