Organization
MISSOURI CVS PHARMACY, L.L.C.
Active
Parent organization
SCHNUCK MARKETS INC
Other names
SCHNUCKS PHARMACY, CVS Pharmacy #18015
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
16580 MANCHESTER RD, WILDWOOD, MO 63040-1217
(636) 458-9934
(636) 458-9274
Mailing address
1 CVS DRICE, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
006053
MO
333600000X
Pharmacy
006053
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2631035
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
608571709
—
MO
Enumeration date
06/17/2006
Last updated
06/26/2020
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