Organization
MISSOURI CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 08563
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIANA MAURICIO (MANAGER PHARMACY ENROLLMENTS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
300 S COMMERCIAL ST., HARRISONVILLE, MO 64701-1282
(816) 380-6566
(816) 360-3826
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MO
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2636744
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
602048605
—
MO
01
—
622048619
DME
MO
Enumeration date
06/16/2006
Last updated
02/01/2021
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