Organization
MARYLAND CVS PHARMACY LLC
Active
Other names
CVS Pharmacy # 10094
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5405 LYNX LANE, COLUMBIA, MD 21044
(410) 740-7273
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENT, 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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087952500 RX
—
MD
05
—
087993200 DME
—
MD
01
—
2138635
NCPDP
MD
Enumeration date
08/18/2014
Last updated
04/08/2015
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