# MISSOURI CVS PHARMACY, L.L.C.

> 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 \#05670
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780911594
- **Authorized official:** SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 9141 OLIVE BLVD, OLIVETTE, MO 63132-3722
- **Practice address phone:** (314) 432-2296
- **Practice address fax:** (314) 432-3354
- **Mailing address:** 1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500
- **Mailing address fax:** (401) 770-7108

## Taxonomy

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

## Other

- **Enumeration date:** 11/16/2009
- **Last updated:** 10/31/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1780911594 | — | MO |
| 01 | — | 2638902 | NCPDP | — |