CVS State Capital LLC
NPI 1003913583ActiveOrganization· Pharmacy· South Portland, ME
Pharmacy in South Portland, Maine, registered in NPPES in September 2006. The authorized official on file is Susan Colbert, Director. Medicare paid $161,725 for services to 604 patients in 2024.
Overview
| NPI | 1003913583 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 19, 2006 |
| Last updated in NPPES | Sep 7, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | PH50000251 | ME |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (ME) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 604 |
|---|---|
| Services billed | 2,030 across 13 procedure codes |
| Paid by Medicare | $161,725 |
Other Pharmacy providers in South Portland
- 1295757946
- 1528582608