Organization
MARYLAND CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #16396
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
3343 CORRIDOR MARKETPLACE, LAUREL, MD 20724-2378
(301) 483-0949
(240) 616-3974
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
P07023
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1040669 00
—
MD
01
—
2035876
PK
—
01
—
3001474 00
DME
MD
Enumeration date
07/24/2006
Last updated
12/20/2016
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