Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY #05661
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIANA MAURICIO (MGR PHCY ENROLLMENTS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
409 E NORTH AVE, BELTON, MO 64012-2016
(816) 331-9716
(816) 331-0145
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
2004023160
MO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2618417
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
600198857
—
MO
Enumeration date
09/22/2006
Last updated
02/03/2015
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