Organization · NPI-2
Missouri Cvs Pharmacy LLC
Pharmacy · Farmington, MO
NPI number1104205749
StatusActive
Last updated in NPPESOct 29, 2018
Details
- NPI
- 1104205749
- Entity type
- Organization (NPI-2)
- Legal business name
- Missouri Cvs Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- May 28, 2015
- Last updated
- Oct 29, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Cvs Pharmacy# 10471 (Doing Business As)
Practice location
101 E Karsch BlvdFarmington, MO 63640-1235
Phone 573-701-0639
Mailing address
1 Cvs DrWoonsocket, RI 02895-6146
Authorized official
Susan Colbert
Director
4017651500
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