NPIMap

Organization Active NPI

Maryland CVS Pharmacy LLC

  • Pharmacy
  • Arnold, MD
National Provider Identifier
1285035204
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MARYLAND CVS PHARMACY LLC
Practice address
1500 Ritchie Hwy
Arnold, MD 21012-2400
Phone
(410) 757-3902
NPI assigned
Sep 9, 2014
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Susan F Colbert
Title
Director, Payer Relations
Phone
(401) 770-2751

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2283797Maryland CVS Pharmacy LLC Dba CVS Pharmacy #030431500 Ritchie Hwy SWC, Arnold, MD 21012Certificate of waiverJun 12, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy # 030431500 Ritchie Hwy, Arnold, MD 21012-2400(410) 757-3902 Immunosuppressive 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|Urological Supplies|Ent… Does not accept assignmentParticipating since Jan 1, 2025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20090916000218 MD Part B Supplier - Mass Immunization (Roster Biller Only) 7719033703 This NPI is an additional NPI on the enrollment
O20150126001505 MD DME Supplier - Pharmacy 7719033703 Practice locations: Arnold, MD

National Provider Directory

National Provider Directory
Tax ID family
CVS Health (192 organizations share this tax ID)

Locations

1500 Ritchie Hwy
Arnold, MD 21012
Phone (410) 757-3902

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

NPPES NPI Registry

Primary practice location

1500 Ritchie Hwy
Arnold, MD 21012-2400

Mailing address

1 CVS Dr
Box 1075 -Pharmacy Enrollment
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
0865702 00 RXMedicaidMD
0865729 00 DMEMedicaidMD
2138673OtherMDNCPDP

Other names 1

NPPES NPI Registry
  • CVS Pharmacy # 03043 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 29, 2015.

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1285035204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075 -PHARMACY ENROLLMENT",
            "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": "1500 RITCHIE HWY",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122400",
            "telephone_number": "410-757-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0865702 00        RX",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0865729 00       DME",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2138673",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy # 03043",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arnold, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.

Verify at the official NPI Registry.