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Contact Information

CVS STATE CAPITAL LLC
111 AUBURN ST
PORTLAND, ME04103-2103
 Phone: 207-797-3393
 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
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for CVS STATE CAPITAL LLC

NPI Number 1427152347
LBN Legal business name CVS STATE CAPITAL LLC
Authorized official SUSAN COLBERT - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/12/2006
Last updated 10/07/2011 - About 15 years ago
Identifiers
ME License # PH50000263
Other 2000230 OTHER ID NUMBER-COMMERCIAL NUMBER
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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