Rea and Derick Inc P 1835

Primary specialty

PharmacyTaxonomy code 333600000X

License

P01188 Issued in MD

Legal business name

REA AND DERICK INC P 1835

Practice address

5500 Buckeystown PK FRCS SCT Key Mall
Frederick, MD 21703

Phone

(301) 662-8606

NPI assigned

Sep 19, 2006

Organization subpart

No

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

Authorized official

Name

Cristiana Mauricio

Title

MGR Phcy Enrollments

Phone

(401) 770-2937

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CVS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1720185218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "PO BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 BUCKEYSTOWN PK FRCS SCT KEY MALL",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21703",
            "telephone_number": "301-662-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REA AND DERICK INC P 1835",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "CRISTIANA",
        "authorized_official_title_or_position": "MGR PHCY ENROLLMENTS",
        "authorized_official_telephone_number": "401-770-2937"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "P01188",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2110649",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Marie Raynes, M.D.
• Bharti Razdan, M.D.
• Ali Razi, MD
• Rda Care Inc
• Re-Create: Therapy and Wellness
• Reaching Infinity LLC
• Amanda Jane Read, CRNP-C
• Shawn Rearden
• Ashley Reaver, RD
• Barbara S. Rebele, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.