Active NPI
Maryland CVS Pharmacy LLC
Doing business as CVS Pharmacy #01505
- Pharmacy
- Upper Marlboro, MD
National Provider Identifier
1952409781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- P01213
- Legal business name
- MARYLAND CVS PHARMACY LLC
- Doing business as
- CVS Pharmacy #01505
- Practice address
- 28 Watkins Drive
Upper Marlboro, MD 20774 - Phone
- (301) 249-4664
- NPI assigned
- Sep 20, 2006
- Last updated
- Feb 14, 2011
- 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 Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | P01213 | MD | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
28 Watkins Drive
Upper Marlboro, MD 20774
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 570067100 - RX | Medicaid | MD | |
| 2113532 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY #01505
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 |
| O20100930023483 | MD | DME Supplier - Pharmacy | 7719033703 | Practice locations: Upper Marlboro, 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 # 01505 | 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 18
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1297641600000",
"number": "1952409781",
"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",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 WATKINS DRIVE",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "20774",
"telephone_number": "301-249-4664"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARYLAND CVS PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-20",
"last_updated": "2011-02-14",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"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": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MD",
"license": "P01213",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "570067100 - RX",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "2113532",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY #01505",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Upper Marlboro, MD
- Vanessa Marshall, LICSW,LCSW-C,LCSW
- Tyra Martin
- Mary's House of Greater Washington, Inc. (Carespring Services)
- Maryland CVS Pharmacy LLC (CVS Pharmacy #16395)
- Maryland CVS Pharmacy LLC (CVS Pharmacy 01795)
- Maryland CVS Pharmacy LLC (CVS Pharmacy # 01470)
- Maryland CVS Pharmacy, L.L.C. (CVS Pharmacy #01456)
- Maryland Healthcare Services Inc (Revival Homecare Agency)
- Maryland Primary Care and Wellness
- Maryland Primary Care and Wellness (Meridian Medical Group)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.