Maryland CVS Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MARYLAND CVS PHARMACY LLC

Doing business as

CVS Pharmacy #16612

Practice address

9901 York Rd
Cockeysville, MD 21030-3407

Phone

(410) 683-6517

Fax

(410) 616-2170

NPI assigned

Jul 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Colbert

Title

Sr. Director, Payer Relations

Phone

(401) 770-2751

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• CVS Pharmacy #16612 Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CVS Pharmacy Inc

  dba CVS Pharmacy #07413

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1235151994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 YORK RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303407",
            "telephone_number": "410-683-6517",
            "fax_number": "410-616-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. 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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P07042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2036880",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #16612",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margeray Nojadera OD PA
• Mikayla Leigh Marsjanik
• Garrette Martin-Yeboah, PHARMD, MPH
• Lyla R Martin
• Maryland Counseling Associates,LLC
• Maryland Masonic Homes. LTD
• Maryland Parent Child Clinic, LLC
• MB Services LLC (MB HomeCare)
• Michael Kamau Mbagu, PHARMACIST
• Theodore McCadden Jr., LCADC, CPP

• Pharmacy in Cockeysville, MD
• Providers in Cockeysville, MD by specialty
• Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.