Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #01435
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1503 POTOMAC AVE, HAGERSTOWN, MD 21742-2930
(301) 733-8515
Mailing address
1 CVS DR, PO BOX 1075, 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
P00498
MD
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2101056
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
4201728 00
—
MD
05
—
6632157 00 - DME
—
MD
01
—
P00754558
MEDICARE RR
MD
Enumeration date
09/12/2006
Last updated
04/21/2011
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