Organization
MARYLAND CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #01790
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
15100 BALTIMORE AVE, LAUREL, MD 20707-4602
(301) 776-5404
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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132417
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
570059100
—
MD
Enumeration date
09/22/2006
Last updated
05/18/2022
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