CVS STATE CAPITAL LLC (NPI# 1508960428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508960428 |
| Entity Type | Organization |
| Organization Name | CVS STATE CAPITAL LLC |
| Other Organization Name | CVS PHARMACY 00620 |
| Practice Address |
1 Kennedy Memorial Dr Waterville ME 04901-5125 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2078737161 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2011-10-07 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | PH50000111 | ME | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2003399 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY 00620 | 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 |
1 KENNEDY MEMORIAL DR |
| City | WATERVILLE |
| State | ME |
| Zip Code | 04901-5125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285111336 | Cheryl Blaisdell | Pharmacist | 1 Kennedy Memorial Dr, Waterville, ME 04901-5125 | 2018-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093325649 | Orthopedic Physical Therapy | Physical Therapist | Orthopedic Physical Therapy, 234 College Ave, Waterville, ME 04901 | 2020-08-07 |
| 1790328771 | Elizabeth Saucier | Counselor | Discovery House 40 Airport Rd, Waterville, ME 04901 | 2019-10-23 |
| 1780233445 | Amy Marie Tardy | Counselor | 325 Kmd, Building D - Unit 4, 325 Kmd - Building D -- Unit 4, Waterville, ME 04901 | 2019-09-05 |
| 1457905911 | Waterville Audiology PC | Audiologist-Hearing Aid Fitter | 124 Silver Street, Waterville, ME 04901 | 2019-08-01 |
| 1629537048 | Samantha Sobel | Behavioral Analyst | 2 Seton Center Dr, Waterville, ME 04901 | 2019-03-15 |
| 1366916025 | Waterville Pharmacy | Pharmacy | 20 Concourse W, Waterville, ME 04901 | 2019-01-16 |
| 1699243733 | Thomas James Demers | Counselor | Discovery House, 40 Airport Road, Waterville, ME 04901 | 2018-11-07 |
| 1851892442 | Alishia M Austin | Counselor | Discovery House Ctc Waterville 40 Airport Rd, Waterville, ME 04901 | 2018-02-28 |
| 1336671056 | Douglas Joseph Dicola | Family Medicine | Mainegeneral Medical Center, 149 North St, Waterville, ME 04901 | 2017-03-31 |
| 1134660020 | Waterville Medical Supplies | Durable Medical Equipment & Medical Supplies | 325 Waterville Commons Drive, Waterville, ME 04901 | 2017-03-13 |
| Find all providers in zip 04901 | ||||
| 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 |
|---|---|---|---|---|
| 1205997020 | Elm City Pharmacy | Pharmacy | 30 W Concourse, Waterville, ME 04901-6007 | 2006-12-13 |
| 1013922632 | Eastmont Pharmacy Inc | Pharmacy | 105 1/2 W Locust, Waterville, WA 98858 | 2006-07-30 |
| 1639532054 | Sears Holding | Pharmacy | 106 Freedom Ln, Waterville, OH 43566-1118 | 2016-04-02 |
| 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 | WATERVILLE |
| Zip Code | 04901 |
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.