National Provider Identifier Database

CVS STATE CAPITAL LLC
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

CVS STATE CAPITAL, L.L.C.
48 PORTLAND RD
KENNEBUNK, ME04043-6631
Phone: 207-467-8299
Fax:
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X

* Indicates primary specialty

NPI Profile & details for CVS STATE CAPITAL, L.L.C.

NPI Number 1962644708
Legal business name
LBN
CVS STATE CAPITAL, L.L.C.
Authorized official SUSAN COLBERT - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 03/25/2009
Last updated 06/18/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • ME Medicaid: 157010004
  • Other: 2008349 NCPDP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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