Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 03087
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F. COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
11560 OLIVE BLVD, CREVE COEUR, MO 63141
(314) 995-7128
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285940957
—
MO
01
—
2639233
NCPDP
—
Enumeration date
08/19/2010
Last updated
10/31/2013
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