Organization
REA AND DERICK INC P 1835
Active
Other names
CVS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIANA MAURICIO (MGR PHCY ENROLLMENTS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
5500 BUCKEYSTOWN PK FRCS SCT KEY MALL, FREDERICK, MD 21703
(301) 662-8606
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
P01188
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110649
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/19/2006
Last updated
02/29/2008
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