Provider Demographics
NPI:1750834172
Name:CVS / PHARMACY
Entity Type:Organization
Organization Name:CVS / PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-350-4979
Mailing Address - Street 1:7035 INDIAN HEAD HWY
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-3234
Mailing Address - Country:US
Mailing Address - Phone:301-375-7450
Mailing Address - Fax:
Practice Address - Street 1:7035 INDIAN HEAD HWY
Practice Address - Street 2:
Practice Address - City:BRYANS ROAD
Practice Address - State:MD
Practice Address - Zip Code:20616-3234
Practice Address - Country:US
Practice Address - Phone:301-375-7450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD233983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy