CVS STATE CAPITAL LLC; NPI #1295757946

Contact Information

CVS STATE CAPITAL LLC

200 RUNNING HILL RD
SOUTH PORTLAND, ME 04106-3258

Phone: 207-871-0911
Fax: 207-871-0911
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Pharmacy	333600000X	58	Medical Supply Company with Pharmacist
Community/Retail Pharmacy	3336C0003X	58	Medical Supply Company with Pharmacist
Durable Medical Equipment & Medical Supplies	332B00000X	54	Other Medical Supply Company

Indicates primary specialty

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NPI Profile & details for CVS STATE CAPITAL LLC

NPI # 1295757946

LBN Legal business name CVS STATE CAPITAL LLC

Authorized official SUSAN COLBERT - (SR. DIRECTOR, PAYER RELATIONS)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/24/2006

Last updated 11/03/2016 - About 10 years ago

Identifiers

ME	License #	PH50001549
	Other	2037512	PK

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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