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Organization

MISSOURI CVS PHARMACY, L.L.C.

Active
Other names
Schnucks Pharmacy743, CVS Pharmacy #18094
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization

Contact information

Practice address
942 VALLEY CREEK DR, FARMINGTON, MO 63640-1968
(573) 664-5202
(573) 664-5203
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
333600000X
Pharmacy
MO
3336C0003X
Community/Retail Pharmacy
Primary
MO

Other

Enumeration date
10/24/2014
Last updated
06/26/2020
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