Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 06614
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, MANAGED CARE CONTRACT ADM)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1008 PULASKI HWY, HAVRE DE GRACE, MD 21078
(410) 939-6427
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, 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
—
029237100 RX
—
MD
05
—
029246000 DME
—
MD
01
—
2134928
NCPDP
MD
Enumeration date
10/27/2009
Last updated
05/31/2018
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