Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Parent organization
SCHNUCK MARKETS INC
Other names
SCHNUCKS PHARMACY, CVS Pharmacy #18004
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
15425 MANCHESTER RD, BALLWIN, MO 63011-3077
(636) 256-7922
(636) 256-6998
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
004766
MO
333600000X
Pharmacy
004766
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2624333
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
602902504
—
MO
Enumeration date
06/17/2006
Last updated
06/26/2020
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