Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Parent organization
SCHNUCK MARKETS INC
Other names
SCHNUCKS PHARMACY, CVS Pharmacy #18029
Organization subpart
Yes
Provider details
NPI number
Legal business name
SCHNUCK MARKETS INC
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
3430 S GRAND BLVD, SAINT LOUIS, MO 63118-1004
(314) 772-5722
(314) 865-4897
Mailing address
1 CVS DR # 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
005098
MO
333600000X
Pharmacy
005098
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2626250
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
602780009
—
MO
Enumeration date
06/25/2006
Last updated
07/08/2020
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