Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Parent organization
SCHNUCK MARKETS INC
Other names
SCHNUCKS PHARMACY 176
Organization subpart
Yes
Provider details
NPI number
Legal business name
SCHNUCK MARKETS INC
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1900 1ST CAPITOL DR, ST. CHARLES, MO 63301-1609
(636) 946-0738
(636) 946-0775
Mailing address
1 CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(314) 994-4586
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
005829
MO
333600000X
Pharmacy
005829
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2629941
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
601371925
—
MO
Enumeration date
06/25/2006
Last updated
06/10/2020
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