Organization
MARYLAND CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #05875
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6001 HIGH BRIDGE ROAD, BOWIE, MD 20720
(301) 262-4956
Mailing address
ONE CVS DRIVE, BOX 1075-PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
P04463
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4201655 00
—
MD
Enumeration date
10/12/2006
Last updated
11/10/2010
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