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Organization

MISSOURI CVS PHARMACY, L.L.C.

Active
Other names
CVS Pharmacy #18011, SCHNUCKS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization

Contact information

Practice address
2030 DORSETT VLG, MARYLAND HEIGHTS, MO 63043-2208
(314) 434-5496
(314) 434-7935
Mailing address
1 CVS DRIVE, 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
006388
MO
333600000X
Pharmacy
006388
MO
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2631655
OTHER ID NUMBER-COMMERCIAL NUMBER
05
609805205
MO
Enumeration date
12/11/2006
Last updated
06/10/2020
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