NPIMap

Organization Active NPI

Maryland CVS Pharmacy LLC

  • Pharmacy
  • Bel Air, MD
National Provider Identifier
1922020676
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MARYLAND CVS PHARMACY LLC
Practice address
580 Marketplace Dr
Bel Air, MD 21014-4310
Phone
(410) 638-9031
Fax
(410) 809-2794
NPI assigned
Jul 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Susan Colbert
Title
Sr. Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X P07064 MD

Addresses

Primary practice location

580 Marketplace Dr
Bel Air, MD 21014-4310

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2035868OtherPK

Other names 1

  • CVS Pharmacy #16391 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090916000218 MD Part B Supplier - Mass Immunization (Roster Biller Only) 7719033703 This NPI is an additional NPI on the enrollment
O20161010002291 MD DME Supplier - Pharmacy 7719033703 Practice locations: Bel Air, 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
Maryland CVS Pharmacy LLC580 Marketplace Dr, Bel Air, MD 21014-4310(410) 638-9031 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 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": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1922020676",
    "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": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 MARKETPLACE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144310",
            "telephone_number": "410-638-9031",
            "fax_number": "410-809-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. 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": "MD",
            "license": "P07064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035868",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #16391",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.