Active NPI
Maryland CVS Pharmacy, L.L.C.
Doing business as CVS Pharmacy #01735
- Pharmacy
- Glen Burnie, MD
National Provider Identifier
1003988783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- P04503
- Legal business name
- MARYLAND CVS PHARMACY, L.L.C.
- Doing business as
- CVS Pharmacy #01735
- Practice address
- 7400 Ritchie Hwy
Glen Burnie, MD 21061-3110 - Phone
- (410) 760-2112
- Fax
- (401) 770-7108
- NPI assigned
- Nov 15, 2006
- Last updated
- Mar 22, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | P04503 | MD | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
7400 Ritchie Hwy
Glen Burnie, MD 21061-3110
Mailing address
1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2133116 | Other | MD | COMMERCIAL NUMBER |
| 6621015 00 | Medicaid | MD |
Other names 1
- CVS Pharmacy #01735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090916000218 | MD | Part B Supplier - Mass Immunization (Roster Biller Only) | 7719033703 | This NPI is an additional NPI on the enrollment |
| O20100930017935 | MD | DME Supplier - Pharmacy | 7719033703 | Practice locations: Glen Burnie, MD |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2283789 | Maryland CVS Pharmacy LLC Dba CVS/ Pharmacy #01735 | Certificate of waiver | Jun 12, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #01735 | Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Maryland CVS Pharmacy LLC
Organizations with this tax ID in the same state 16
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- General Acute Care Hospital
- Upper Marlboro, MD
- NPI 1003225012
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1332374400000",
"number": "1003988783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 RITCHIE HWY",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210613110",
"telephone_number": "410-760-2112",
"fax_number": "401-770-7108"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARYLAND CVS PHARMACY, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-15",
"last_updated": "2012-03-22",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MD",
"license": "P04503",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL NUMBER",
"identifier": "2133116",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6621015 00",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #01735",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Glen Burnie, MD
- Erin Martin, LCMFT
- Shannon Nicole Martin, FNP-C
- Maryland CVS Pharmacy LLC (CVS Pharmacy # 05706)
- Maryland CVS Pharmacy LLC (CVS Pharmacy #16392)
- Maryland CVS Pharmacy LLC (CVS Pharmacy #17055)
- Maryland Family Care, Inc.
- Maryland Heart Associatesllc
- Maryland Institute of Neurolgical Disorders and Sleep, P.a.
- Maryland Physical Therapy (Keith B. Rohr, P.T.)
- Maryland Primary Care Physicians, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.