Organization
MARYLAND CVS PHARMACY LLC
Active
Other names
CVS Pharmacy # 03517
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
825 WAYNE AVE, SILVER SPRING, MD 20910-4427
(301) 562-5414
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
01
—
2135855
NCPDP
MD
05
—
2202051 00
—
MD
05
—
5560080 00
—
MD
Enumeration date
06/16/2011
Last updated
02/01/2012
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