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General NPI Number Information
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NPI Number | 1811396104
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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 | 08/22/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 1460B W PATRICK ST
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City | FREDERICK
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State | MD
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Zip | 21702-3750
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Country | US
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Telephone | 301-662-9522
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Fax |
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Provider Business Mailing Address
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Address Line | 4851 MARSDEN PL
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City | FREDERICK
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State | MD
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Zip | 21703-6822
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Country | US
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Telephone | 240-566-2703
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | BOBBY PANDIARAJAN
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Credential |
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Telephone | 301-662-9522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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