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Contact Information

MARYLAND CVS PHARMACY, L.L.C.
10692 CAMPUS WAY SOUTH KETTERING SC
UPPER MARLBORO, MD20774
 Phone: 301-336-2900
 Fax:
 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
 

Emergency Response System Companies

333300000X A5 All Other Suppliers
Indicates primary specialty

NPI Profile & details for MARYLAND CVS PHARMACY, L.L.C.

NPI # 1376640862
LBN Legal business name MARYLAND CVS PHARMACY, L.L.C.
Authorized official SUSAN COLBERT - (DIRECTOR, PAYER RELATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 09/19/2006
Last updated 11/12/2010 - About 16 years ago
Identifiers
MD License # P00519
MD Medicaid 3922057 00
Other 2101905 OTHER ID NUMBER-COMMERCIAL NUMBER
MD Other P00754558 MEDICARE RR
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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