# MISSOURI CVS PHARMACY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS Pharmacy\# 10281
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679906226
- **Authorized official:** SUSAN COLBERT (DIRECTOR)
- **Authorized official phone:** (401) 765-1500

## Contact information

- **Practice address:** 225 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-4846
- **Practice address phone:** (573) 785-7582
- **Mailing address:** 1 CVS DR, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | — | — |
| 333600000X | Pharmacy | — | — | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 08/19/2013
- **Last updated:** 03/31/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1679906226 | — | MO |
| 05 | — | 205009407 | — | AR |
| 01 | — | 206464716 | DME | AR |
| 01 | — | 2641353 | NCPDP | MO |