Provider Demographics
NPI:1417361742
Name:CORMIER, KERRY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:
Last Name:CORMIER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10692 CAMPUS WAY S
Mailing Address - Street 2:CVS REGIONAL BUSINESS OFFICE
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1307
Mailing Address - Country:US
Mailing Address - Phone:202-222-5994
Mailing Address - Fax:401-652-0895
Practice Address - Street 1:10692 CAMPUS WAY S
Practice Address - Street 2:CVS REGIONAL BUSINESS OFFICE
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1307
Practice Address - Country:US
Practice Address - Phone:202-222-5994
Practice Address - Fax:401-652-0895
Is Sole Proprietor?:No
Enumeration Date:2014-06-14
Last Update Date:2014-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21323183500000X
VA0202207887183500000X
DCPH100001189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist