Organization
MISSOURI CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #17069
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1272 TOWN AND COUNTRY CROSSING DR, CHESTERFIELD, MO 63017-0605
(636) 591-0235
(636) 591-0245
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
2008015193
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049645
PK
—
Enumeration date
06/19/2008
Last updated
11/21/2016
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