Organization
MISSOURI CVS PHARMACY LLC
Active
Other names
CVS Pharmacy# 10160
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
112 E 32ND ST, JOPLIN, MO 64804-3801
(417) 623-1883
Mailing address
1 CVS DR, 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
—
1427466408
—
MO
05
—
200526060B
—
OK
01
—
200526060C
DME
OK
01
—
2642002
NCPDP
—
Enumeration date
07/23/2014
Last updated
12/17/2014
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