CVS STATE CAPITAL LLC (NPI# 1134223050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134223050 |
| Entity Type | Organization |
| Organization Name | CVS STATE CAPITAL LLC |
| Other Organization Name | CVS PHARMACY 00374 |
| Practice Address |
449 Forest Ave Portland ME 04101-2029 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2077721928 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-03-05 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | PH50000256 | ME | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2003767 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY 00374 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972789311 | Cvs State Capital LLC | Pharmacy | 119 Crossing Way, Augusta, ME 04330-6102 | 2008-01-16 |
| 1609958073 | Cvs State Capital LLC | Durable Medical Equipment & Medical Supplies | 430 Mariner Way, Biddeford, ME 04005-9440 | 2006-10-19 |
| 1386741866 | Cvs State Capital LLC | Durable Medical Equipment & Medical Supplies | 1096 Brighton Ave, Pine Tree Sc, Portland, ME 04102-1030 | 2006-09-19 |
| 1477650950 | Cvs State Capital LLC | Durable Medical Equipment & Medical Supplies | 10 East Ave Lewiston Sc, Lewiston, ME 04240 | 2006-09-19 |
| 1194822676 | Cvs State Capital LLC | Durable Medical Equipment & Medical Supplies | 1406 Congress St West Gate Sc, Portland, ME 04102 | 2006-09-19 |
| 1235233156 | Cvs State Capital LLC | Durable Medical Equipment & Medical Supplies | 131 Court St, Bath, ME 04530-2054 | 2006-09-12 |
| 1427152347 | Cvs State Capital LLC | Durable Medical Equipment & Medical Supplies | 111 Auburn St, Portland, ME 04103-2103 | 2006-09-12 |
| 1881798700 | Cvs State Capital LLC | Durable Medical Equipment & Medical Supplies | 510 Congress St, Portland, ME 04101-3416 | 2006-09-12 |
| 1063516987 | Cvs State Capital LLC | Pharmacy | 770 Roosevelt Trl, Windham, ME 04062-5300 | 2006-09-12 |
| 1053415976 | Cvs State Capital LLC | Pharmacy | 797 Main St Ste D, Sanford, ME 04073-3536 | 2006-09-12 |
| Street Address |
449 FOREST AVE |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-2029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114912664 | Kathleen A Norris | Chiropractor | 449 Forest Ave, 2nd Floor, Portland, ME 04101-2029 | 2005-09-12 |
| 1144829953 | Hannah Freeman Smith | Naturopath | 449 Forest Ave, Portland, ME 04101-2029 | 2020-10-22 |
| 1740751627 | Frances Anna Mae Baconguis Dysinger | Pharmacist | 449 Forest Ave, Portland, ME 04101-2029 | 2018-12-17 |
| 1770055659 | Sarah Elizabeth Sweatt | Pharmacist | 449 Forest Ave, Portland, ME 04101-2029 | 2018-12-17 |
| 1225577521 | Natalie Harmon Veilleux | Counselor | 449 Forest Ave, 2nd Floor, Portland, ME 04101-2029 | 2017-02-20 |
| 1679945810 | Marybeth Riley | Counselor | 449 Forest Ave, Suite #14, Portland, ME 04101-2029 | 2015-10-27 |
| 1790164648 | Shannon Wong | Contractor | 449 Forest Ave, Portland, ME 04101-2029 | 2015-05-26 |
| 1083944821 | Atlantic Chiropractic Limited Liability Company | Chiropractor | 449 Forest Ave, 2nd Floor, Portland, ME 04101-2029 | 2009-12-29 |
| 1588826713 | Guy H Mcchesney | Contractor | 449 Forest Ave, Suite 6, Portland, ME 04101-2029 | 2008-06-29 |
| 1235331885 | Robin D Henry-pearl | Specialist | 449 Forest Ave, 2nd Floor, Portland, ME 04101-2029 | 2007-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
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| 1275946428 | Rite Aid | Pharmacy | 11190 Sw Barnes Dr, Portland, OR 97225 | 2014-06-05 |
| 1033482385 | Strategic Pharmaceutical Solutions Inc | Pharmacy | 17014 Ne Sandy Blvd, Portland, OR 97230-5074 | 2012-02-17 |
| 1811212798 | Luke-dorf, Inc. | Pharmacy | 11349 Ne Sandy Blvd., Portland, OR 97220-1461 | 2010-04-02 |
| 1417100447 | Procare Pharmacy, L.L.C. | Pharmacy | 141 Preble St, Portland, ME 04101-2440 | 2008-11-04 |
| 1811140841 | Coastal Pharmacy LLC | Pharmacy | 29 Marginal Way, Suite 4, Portland, ME 04101-1914 | 2008-11-04 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.