CVS STATE CAPITAL LLC (NPI# 1295757946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295757946 |
| Entity Type | Organization |
| Organization Name | CVS STATE CAPITAL LLC |
| Other Organization Name | CVS PHARMACY #16678 |
| Practice Address |
200 Running Hill Rd South Portland ME 04106-3258 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2078710911 |
| Practice Fax Number | 2078710911 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-11-03 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| 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 |
PH50001549 | ME | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2037512 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16678 | 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 |
200 RUNNING HILL RD |
| City | SOUTH PORTLAND |
| State | ME |
| Zip Code | 04106-3258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124572292 | Alexander Kolb | Pharmacist | 200 Running Hill Rd, Cvs Pharmacy, South Portland, ME 04106-3258 | 2016-08-06 |
| 1154711760 | Jayne Denehy | Pharmacy Technician | 200 Running Hill Rd, South Portland, ME 04106-3258 | 2015-02-03 |
| 1295130425 | Audrey Sanicola | Pharmacist | 200 Running Hill Rd, South Portland, ME 04106-3258 | 2014-10-30 |
| 1437397130 | Lisa Ann Lane | Pharmacist | 200 Running Hill Rd, South Portland, ME 04106-3258 | 2009-02-03 |
| 1770739377 | Kimberly Anne Robinson | Pharmacist | 200 Running Hill Rd, South Portland, ME 04106-3258 | 2008-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513748 | Rayna Louise Sage | Behavior Technician | 50 Donald Beaver Drrive, Ste B, Portland, ME 04106 | 2020-09-17 |
| 1972127330 | Scott M Davis Md LLC | Internal Medicine | 89 Cannon Road, South Portland, ME 04106 | 2020-06-02 |
| 1568013936 | Clara Cassidy | Behavior Technician | 50 Donald Bean Dr, Ste B, South Portland, ME 04106 | 2019-09-26 |
| 1336614346 | Kari Whitney | Nurse Practitioner | Vna Home Health Hospice, 50 Foden Road, Suite 1, South Portland, ME 04106 | 2018-10-05 |
| 1588152193 | Kristen F. Pierce | Counselor | 100 Waterman Drive, Suite 201, South Portland, ME 04106 | 2018-04-30 |
| 1649779224 | Jennifer Rene Johnson | Social Worker | 135 Westbrook St, South Portland, ME 04106 | 2018-02-08 |
| 1154847721 | Integral Nutrition, LLC | Dietitian, Registered | 59 Baltimore Avenue, South Portland, ME 04106 | 2017-08-16 |
| 1730619610 | John Preston Powell | Psychiatry & Neurology | 68 B Street Apt 4, South Portland, ME 04106 | 2017-06-14 |
| 1649706268 | Gisselle Mani | Student in an Organized Health Care Education/Training Program | 30 Lydia Ln Apt 2115, South Portland, ME 04106 | 2017-05-02 |
| 1245786987 | Jonathan Frank Olmes | Optometrist | 335 Maine Mall Rd., South Portland, ME 04106 | 2016-09-01 |
| Find all providers in zip 04106 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245601061 | Bedard Pharmacy, Inc. | Pharmacy | 5 Horton St, Lewiston, ME 04240-6828 | 2015-10-20 |
| 1811392921 | M Drug LLC | Pharmacy | 401 N Main St Ste A&b, Brewer, ME 04412-1873 | 2014-10-31 |
| 1164849691 | Eastport Family Pharmacy | Pharmacy | 34 Middle St, Eastport, ME 04631 | 2014-03-21 |
| 1588080337 | The Island Employee Cooperative Inc | Pharmacy | 3 Burnt Cove Rd, Stonington, ME 04681-3301 | 2014-03-17 |
| 1679812200 | Frontier Pharmacy LLC | Pharmacy | 153 Bennett Dr, Caribou, ME 04736-2024 | 2013-02-01 |
| 1568759058 | Mt Blue Drug Inc | Pharmacy | 624 Wilton Rd, Farmington, ME 04938-6138 | 2011-07-05 |
| 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 |
| 1013041557 | Colonial Pharmacy Inc | Pharmacy | 40 Dock Sq, Kennebunkport, ME 04046-6011 | 2007-03-15 |
| 1528196219 | Moosehead Drug Inc. | Pharmacy | 10 Pritham Ave, Greenville, ME 04441 | 2007-03-02 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH PORTLAND |
| Zip Code | 04106 |
Please comment or provide details below to improve the information on CVS STATE CAPITAL LLC.
| 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.