Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 10171
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
696-698 NORTH HWY 67 ST., FLORISSANT, MO 63031-5106
(314) 830-7881
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MO
333600000X
Pharmacy
Primary
—
MO
3336C0003X
Community/Retail Pharmacy
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093163792
—
MO
01
—
2643434
NCPDP
MO
Enumeration date
06/03/2016
Last updated
02/01/2021
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