NPIMap

Organization Active NPI

Maryland CVS Pharmacy, L.L.C.

Doing business as CVS Pharmacy #11452

  • Pharmacy
  • Chevy Chase, MD
National Provider Identifier
1417636218
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MARYLAND CVS PHARMACY, L.L.C.
Doing business as
CVS Pharmacy #11452
Practice address
3820 Chaplin PL Ste 102
Chevy Chase, MD 20815-4168
Phone
(401) 765-1500
NPI assigned
Jul 18, 2023
Last updated
Sep 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Susan F Colbert
Title
Sr. Director
Phone
(401) 765-1500

Specialties & licenses 3

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

Addresses

Primary practice location

3820 Chaplin PL Ste 102
Chevy Chase, MD 20815-4168

Mailing address

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

Other names 1

  • CVS Pharmacy #11452 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090928000399 DC Part B Supplier - Mass Immunization (Roster Biller Only) 7719033703 This NPI is an additional NPI on the enrollment
O20240404002722 MD DME Supplier - Pharmacy 7719033703 Practice locations: Chevy Chase, MD

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #114523820 Chaplin PL, Chevy Chase, MD 20815-4168(301) 634-2128 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

National Provider Directory

National Provider Directory
Tax ID family
CVS Health192 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1417636218",
    "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": "02895",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 CHAPLIN PL STE 102",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154168",
            "telephone_number": "401-765-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR. DIRECTOR",
        "authorized_official_telephone_number": "401-765-1500"
    },
    "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #11452",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CVS Pharmacy #11452",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.