CVS State Capital LLC
NPI 1164140398ActiveOrganization· Pharmacy· Auburn, ME
Pharmacy in Auburn, Maine, registered in NPPES in August 2022. The authorized official on file is Susan F. Colbert, Sr. Director. Medicare paid $17,016 for services to 69 patients in 2024.
Overview
| NPI | 1164140398 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 15, 2022 |
| Last updated in NPPES | Aug 15, 2022 |
| Certified by provider | Aug 11, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| 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 | 69 |
|---|---|
| Services billed | 220 across 8 procedure codes |
| Paid by Medicare | $17,016 |
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