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CVS STATE CAPITAL LLC NPI 1053415976


NPI Information

NPI: 1053415976
Provider Name: CVS STATE CAPITAL LLC

Doing Business As: CVS PHARMACY 00523

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
797 MAIN ST STE D
SANFORD, ME
ZIP 04073
Phone: (207) 324-3110
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CVS STATE CAPITAL LLC is a pharmacy in Sanford, ME. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. CVS STATE CAPITAL LLC NPI is 1053415976. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy 00523.

The provider's business location address is:

797 MAIN ST STE D
SANFORD, ME
ZIP 04073-536
Phone: (207) 324-3110

The provider's authorized official is Susan Colbert .
The authorized official title is Director and has the following contact phone number (401) 765-1500.

The enumeration date for this NPI number is 9/12/2006 and was last updated on 3/6/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacyPH50000902MAINEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00959033MEDICARE PIN
22003705OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
30506640003MEDICARE NSC
40015942MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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