Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy #18021, SCHNUCKS PHARMACY 129
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
8660 VETERANS MEMORIAL PKWY, O'FALLON, MO 63366-7537
(636) 978-3568
(636) 272-8516
Mailing address
1 CVS DRIVE, BOX 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
004208
MO
333600000X
Pharmacy
004208
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2620614
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
602902108
—
MO
Enumeration date
06/17/2006
Last updated
06/26/2020
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