Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy #11308
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
400 W CLAY AVE, PLATTSBURG, MO 64477
(816) 539-2121
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
01
—
2600117
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/25/2006
Last updated
09/07/2018
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