| Organization Name: | CVS |
| NPI Number: | 1023485539 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENNIFER REZAKHAN (DISTRICT MANAGER) |
| Mailing Address: | 6480 Old Waterloo Road Elkridge |
| State: | MD US |
| Postal Code: | 21075 |
| Phone Number: | 4107990291 |
| Fax Number: | |
| NPI Enumeration Date: | 09/01/2015 |
| NPI Last Update Date: | 09/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | 23561 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |