MEDICARE: CVS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	22883	MD

General Provider Information

NPI Number	:	1568850766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CVS

Provider Business Mailing Address
First Line	:	14508 EDGEWOODS WAY
Second Line	:
City	:	GLENELG
State	:	MD
Zip	:	21737-9608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 TWIN ARCH RD
Second Line	:
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-4138
Country	:	US
Telephone Number	:	301-829-0966
Fax Number	:

Authorized Official
Title or Position	:	DM
Name	:	CORTNEY SPITTAL
Credential	:
Telephone Number	:	401-665-6519

Provider Enumeration Date	:	12/23/2014
Last Update Date	:	12/23/2014

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Directions to “CVS ” Practice Location

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