Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy #11316
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
941 CHEROKEE DR STE 1, MARSHALL, MO 65340
(660) 886-5558
Mailing address
1 CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(660) 886-6320
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
—
600305213
—
MO
Enumeration date
11/02/2006
Last updated
09/07/2018
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