# MISSOURI CVS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS PHARMACY \#08567
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790729168
- **Authorized official:** CRISTIANA MAURICIO (MANAGER PHARMACY ENROLLMENTS)
- **Authorized official phone:** (401) 770-2937

## Contact information

- **Practice address:** 5011 MAIN ST, KANSAS CITY, MO 64112-2756
- **Practice address phone:** (816) 531-4699
- **Mailing address:** 1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | — | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 06/16/2006
- **Last updated:** 02/03/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2636833 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |