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 codeDescriptionLicenseStatePrimary
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 Blvd
Farmington, MO 63640-1235

Phone 573-701-0639

Mailing address

1 Cvs Dr
Woonsocket, RI 02895-6146

Authorized official

Susan Colbert
Director
4017651500

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Pharmacy providers in Farmington, MO