Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy #18016, SCHNUCKS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
20 DILLON PLAZA DR, HIGH RIDGE, MO 63049-2478
(636) 677-0430
(636) 677-2345
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
006121
MO
333600000X
Pharmacy
006121
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2631186
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
608666806
—
MO
Enumeration date
06/20/2006
Last updated
06/26/2020
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