MISSOURI CVS PHARMACY, L.L.C (NPI# 1427043413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427043413 |
| Entity Type | Organization |
| Organization Name | MISSOURI CVS PHARMACY, L.L.C |
| Other Organization Name | CVS PHARMACY #11407 |
| Practice Address |
805 N Kentucky Ave Suite 2 West Plains MO 65775-2045 |
| Mailing Address |
1 Cvs Drive Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 4172562274 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2019-06-26 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 005315 | MO | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 600305510 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #11407 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760933469 | Missouri Cvs Pharmacy, L.l.c | Durable Medical Equipment & Medical Supplies | 10820 Manchester Rd, Kirkwood, MO 63122 | 2016-10-18 |
| Street Address |
805 N KENTUCKY AVE SUITE 2 |
| City | WEST PLAINS |
| State | MO |
| Zip Code | 65775-2045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003330713 | Burton Creek Rural Clinic, LLC | Family Medicine | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2017-08-03 |
| 1710379201 | Lisa Marie Wade | Nurse Practitioner | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2015-02-20 |
| 1992133979 | Lynn Crites | Nurse Practitioner | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2013-10-29 |
| 1124456207 | Patricia Chapin | Pharmacist | 805 N Kentucky Ave, Suite 2, West Plains, MO 65775-2022 | 2013-10-28 |
| 1740553288 | Brett Elizabeth Young | Social Worker | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2012-02-14 |
| 1609167402 | Charles Nathaniel Swift | Internal Medicine | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2011-04-27 |
| 1003140963 | Leslie Erin Barr | Family Medicine | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2009-09-25 |
| 1346300969 | Curtis L Horstman | Family Medicine | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2006-12-12 |
| 1275628349 | Aaron Lee Mills | Family Medicine | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2006-10-04 |
| 1366413262 | Kelly Lynn Mills | Physician Assistant | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2006-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373359 | Ozarks Medical Center | Clinic/Center | Omc/zizzer Clinic, 1013 College Street, West Plains, MO 65775 | 2020-07-17 |
| 1962958678 | Fanny Ray | Massage Therapist | 1105 Independence Drive, West Plains, MO 65775 | 2016-09-01 |
| 1295184166 | Shaunda Faye Wolfe | Case Manager/Care Coordinator | 2301 K Hwy Apt. 2, West Plains, MO 65775 | 2016-06-10 |
| 1740694009 | Mary Loretta Rogganbuck | Counselor | 1211 Porter Wagoner #23, West Plains, MO 65775 | 2014-06-16 |
| 1548673858 | John Tollenaar | Physical Therapist | 1480 8th Streeet, West Plains, MO 65775 | 2014-06-04 |
| 1861818080 | Raymond Eugene Richardson | Case Manager/Care Coordinator | 1015 Lanton Road, West Plains, MO 65775 | 2014-03-12 |
| 1710309083 | Jared M Sadowitz | Physical Therapist | 1100 Kentucly Ave, West Plains, MO 65775 | 2014-01-06 |
| 1346682184 | Mark L. Dake Dds, Msd and David Sander Dmd, Mds | Dentist | 181 N. Kentucky, Suite 300, West Plains, MO 65775 | 2013-07-22 |
| 1427307024 | Anita M. Nelson | Behavioral Analyst | 8388 Pr 2731, West Plains, MO 65775 | 2012-08-29 |
| 1780959684 | Ozarks Medical Center | Pharmacy | 18 Parkway Center, West Plains, MO 65775 | 2012-03-12 |
| Find all providers in zip 65775 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124416839 | Lisa Renee Davidson | Pharmacist | 517 Winchester Dr, West Plains, MO 65775-3936 | 2015-01-03 |
| 1851691125 | Anna Mcwilliams | Pharmacist | 10909 Cr 8530, West Plains, MO 65775 | 2010-11-02 |
| 1558582064 | Maureen Gaye Vance | Pharmacist | 1100 N. Kentucky, West Plains, MO 65775 | 2007-05-01 |
| 1265653877 | William A Hart | Pharmacist | 8336 County Road 8040, West Plains, MO 65775 | 2007-05-01 |
| 1487730255 | Floyd Wilkening | Pharmacist | 1903 Lexington St, West Plains, MO 65775-1661 | 2006-10-27 |
| 1336237650 | Ozark Compounding, Inc. | Pharmacist | 2500 Independence Sq, West Plains, MO 65775-4234 | 2006-10-11 |
| 1134101009 | Bradford Pharmacy Services Inc | Pharmacist | 307 Kentucky Ave, West Plains, MO 65775 | 2005-11-16 |
| 1851991046 | Meghan Thompson | Pharmacist | 1310 Preacher Roe Blvd, West Plains, MO 65775-2998 | 2020-10-28 |
| 1093328023 | Sohad Guirguis | Pharmacist | 1010 Worley Dr, West Plains, MO 65775-5257 | 2020-08-28 |
| 1568075570 | Ashlee Lonon | Pharmacist | 1010 Worley Dr, West Plains, MO 65775-5257 | 2020-08-28 |
| Find all providers in WEST PLAINS | ||||
| City | WEST PLAINS |
| Zip Code | 65775 |
Please comment or provide details below to improve the information on MISSOURI CVS PHARMACY, L.L.C.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.