Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #01796
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4200 ALTAMONT PLACE, WHITE PLAINS, MD 20695
(301) 645-2774
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
P01583
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117061
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3621120 00
—
MD
01
—
P00754558
MEDICARE RR
MD
01
—
P00754558
MEDICARE RR
—
Enumeration date
09/19/2006
Last updated
11/23/2010
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