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General NPI Number Information
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NPI Number | 1558805994
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Entity Type | Organization
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Legal Business Name | CVS PHARMACY
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Dates
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Enumeration Date | 12/04/2016
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Last Update Date | 12/04/2016
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Provider Practice Location Address
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Address Line | 4451 TELFAIR BLVD APT 3084
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City | CAMP SPRINGS
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State | MD
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Zip | 20746-5255
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Country | US
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Telephone | 813-416-9439
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Fax |
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Provider Business Mailing Address
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Address Line | 4451 TELFAIR BLVD APT 3084
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City | CAMP SPRINGS
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State | MD
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Zip | 20746-5255
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Country | US
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Telephone | 813-416-9439
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. YOLANDA FEDORA HOLMES
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Credential | PHARMD.
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Telephone | 813-416-9439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 24615
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License Number State | MD
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