Organization
MARYLAND CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 02010
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1102 ANNAPOLIS RD, ODENTON, MD 21113-1602
(410) 674-8338
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(400) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
P01863
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119964
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
6655025 00
—
MD
Enumeration date
09/19/2006
Last updated
11/07/2013
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