Active NPI
Maryland CVS Pharmacy LLC
Doing business as CVS Pharmacy #05875
- Pharmacy
- Bowie, MD
National Provider Identifier
1699864744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- P04463
- Legal business name
- MARYLAND CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy #05875
- Practice address
- 6001 High Bridge Road
Bowie, MD 20720 - Phone
- (301) 262-4956
- NPI assigned
- Oct 12, 2006
- Last updated
- Nov 10, 2010
- 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 F Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | P04463 | MD | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
6001 High Bridge Road
Bowie, MD 20720
Mailing address
One CVS Drive
Box 1075-Pharmacy Enrollments
Woonsocket, RI 02895
Phone (401) 765-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4201655 00 | Medicaid | MD |
Other names 1
- CVS Pharmacy #05875
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090928000399 | DC | Part B Supplier - Mass Immunization (Roster Biller Only) | 7719033703 | This NPI is an additional NPI on the enrollment |
| O20100930073717 | MD | DME Supplier - Pharmacy | 7719033703 | Practice locations: Bowie, 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.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #05875 | 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 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
6001 High Bridge Rd
Bowie, MD 20720
Phone (240) 696-2170
6001 High Bridge Rd
#5875
Bowie, MD 20720
Phone (301) 262-4956
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1289347200000",
"number": "1699864744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE CVS DRIVE",
"address_2": "BOX 1075-PHARMACY ENROLLMENTS",
"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": "6001 HIGH BRIDGE ROAD",
"city": "BOWIE",
"state": "MD",
"postal_code": "20720",
"telephone_number": "301-262-4956"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARYLAND CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-12",
"last_updated": "2010-11-10",
"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": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MD",
"license": "P04463",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4201655 00",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #05875",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bowie, MD
- Phillip Sidney Martin, DDS
- Marvelous Care Homes LLC
- Mary Blotzer LCSW C PA
- Maryland Brain Spine & Pain LLC
- Maryland CVS Pharmacy LLC (CVS Pharmacy #16393)
- Maryland CVS Pharmacy LLC (CVS Pharmacy #17102)
- Maryland CVS Pharmacy, L.L.C. (CVS Pharmacy # 01454)
- Maryland Emergency Medicine Network Physicians, LLC
- Maryland Health Services LLC
- 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 Nov 10, 2010; 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.