NPIMap

Organization Active NPI

CVS

  • Pharmacist
  • Upper Marlboro, MD
National Provider Identifier
1508273657
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14747 Issued in MD
Legal business name
CVS
Practice address
5100 Brown Station Rd
Upper Marlboro, MD 20772-9132
Phone
(301) 627-1500
NPI assigned
Jul 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Authorized official

Name
Kendra Prater
Title
Pharmacy Supervisor
Phone
(571) 308-4490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 14747 MD Primary

Addresses

Primary practice location

5100 Brown Station Rd
Upper Marlboro, MD 20772-9132

Mailing address

5100 Brown Station Rd
Upper Marlboro, MD 20772-9132
Phone (301) 627-1500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1508273657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 BROWN STATION RD",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207729132",
            "telephone_number": "301-627-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BROWN STATION RD",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207729132",
            "telephone_number": "301-627-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "PRATER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "571-308-4490"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "14747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.