MISSOURI CVS PHARMACY LLC (NPI# 1609060789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609060789 |
Entity Type | Organization |
Organization Name | MISSOURI CVS PHARMACY LLC |
Other Organization Name | CVS PHARMACY #17410 |
Practice Address |
1883 Wentzville Pkwy Wentzville MO 63385-3896 |
Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
Practice Telephone | 6366397434 |
Practice Fax Number | 6366397444 |
Mailing Telephone | 4017651500 |
Enumeration Date | 2007-08-31 |
Last Update Date | 2016-11-21 |
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 |
---|---|---|---|---|---|
N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2007029735 | MO | Suppliers |
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
Y | 333600000X | Pharmacy | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2049569 | 01 |
Other Name | Type Code |
---|---|
CVS Pharmacy #17410 | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902437460 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6211 Delmar Blvd, Saint Louis, MO 63130-4814 | 2020-02-03 |
1699133678 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3320 North Belt Highway, St Joseph, MO 64506 | 2016-02-04 |
1811365257 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1589 Bryan Rd, O'fallon, MO 63366-3709 | 2015-09-02 |
1003282138 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 200 Jungermann Rd, Saint Peters, MO 63376-5347 | 2015-08-12 |
1104205749 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 101 E Karsch Blvd, Farmington, MO 63640-1235 | 2015-05-28 |
1619371077 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2120 W Osage St, Pacific, MO 63069-1101 | 2014-10-14 |
1427458496 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1550 S New Florissant Rd, Florissant, MO 63031-8123 | 2014-08-27 |
1427466408 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 112 E 32nd St, Joplin, MO 64804-3801 | 2014-07-23 |
1487060570 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2100 1st Capitol Dr, St. Charles, MO 63301 | 2014-07-09 |
1003230335 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8021 Watson Rd, Webster Groves, MO 63119-5304 | 2014-02-06 |
Street Address |
1883 WENTZVILLE PKWY |
City | WENTZVILLE |
State | MO |
Zip Code | 63385-3896 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619380045 | Farhad J Khave | Pharmacist | 1883 Wentzville Pkwy, Wentzville, MO 63385-3896 | 2014-06-03 |
1699060186 | Steven Matthew Fine | Pharmacist | 1883 Wentzville Pkwy, T-2345, Wentzville, MO 63385-3896 | 2011-06-13 |
1518252147 | Meghan Nicole Kohler | Pharmacist | 1883 Wentzville Pkwy, T-2345, Wentzville, MO 63385-3896 | 2011-06-11 |
1255655064 | Leslie Albert Price | Pharmacist | 1883 Wentzville Pkwy, Wentzville, MO 63385-3896 | 2010-03-23 |
1356597702 | Adam L Mcintosh | Pharmacist | 1883 Wentzville Pkwy, Wentzville, MO 63385-3896 | 2008-08-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235730243 | Jeffery William Ellis | Pharmacist | 1571 Wentzville Parkway, Wentzville, MO 63385 | 2020-11-05 |
1487266011 | Jason Wade Moore | Peer Specialist | 5 West Pearce Boulevard, Wentzville, MO 63385 | 2020-08-17 |
1265906176 | Montrice M Haynes | Counselor | 500 Medical Dr., Central Intake, Wentzville, MO 63385 | 2019-01-14 |
1841718459 | Linda Duree | Counselor | 7105 Whisper Creek Dr, Wentzville, MO 63385 | 2017-09-03 |
1811349368 | Sara Kleinlein | Social Worker | 500 Medical Drive, Wentzville, MO 63385 | 2016-07-08 |
1275980757 | Teona Moeller | Nurse Practitioner | 1598 West Meyer Dr., Wentzville, MO 63385 | 2016-05-16 |
1831561273 | Jay F. Hauser, Dds, PC | Dentist | 11 Wentzville Bluffs Drive, Wentzville, MO 63385 | 2015-10-26 |
1720402035 | Shara Kuehl | Speech-Language Pathologist | One Campus Drive, Wentzville, MO 63385 | 2014-02-06 |
1336480474 | Simply Loyal In Home and Transport Services LLC | Home Health | 152 Enterprise Dr, Wentzille, MO 63385 | 2013-03-14 |
1750641338 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1849 Wentzville Parkway, Wentzville, MO 63385 | 2012-05-17 |
Find all providers in zip 63385 |
Taxonomy Code | 333600000X |
Grouping | Suppliers |
Classification | Pharmacy |
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386174894 | Lake Forest Pharmacy | Pharmacy | 950 Corporate Pkwy Ste 104, Wentzville, MO 63385-4851 | 2017-06-16 |
1033283502 | The Corner Drugstore Inc | Pharmacy | 1251 Wentzville Pkwy, Wentzville, MO 63385-3749 | 2006-11-17 |
1760572705 | Dierbergs Markets Inc | Pharmacy | 1820 Wentzville Parkway, Wentzville, MO 63385 | 2006-10-13 |
1154728640 | Ssm Health Care St Louis | Pharmacy | 500 Medical Dr, Wentzville, MO 63385-3421 | 2014-11-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912506437 | E Health Pharmacy, LLC | Pharmacy | 411d Northview Rd, Nixa, MO 65714-8679 | 2020-10-26 |
1750994869 | Script Partner Pharmacy LLC | Pharmacy | 100 Chesterfield Bus Pkwy Ste 279, Chesterfield, MO 63005-1271 | 2020-08-28 |
1821600545 | Debbie S Pharmacy LLC | Pharmacy | 815 Hazelwest Dr Ste 100, Hazelwood, MO 63042-1762 | 2020-08-24 |
1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
1023626389 | Lemonaid Community Pharmacy, Inc | Pharmacy | 7580 Watson Rd, Saint Louis, MO 63119-4409 | 2020-07-22 |
1689207870 | Washington University Cancer Center Pharmacy - North County | Pharmacy | 1225 Graham Rd Fl 1, Florissant, MO 63031-8012 | 2020-02-17 |
1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
1720624323 | Toney Drug & Wellness, LLC | Pharmacy | #1 Hals Plaza Dr, Piedmont, MO 63957 | 2019-11-19 |
1427606912 | Medley Pharmacy Inc | Pharmacy | 1024 S Bishop Ave, Rolla, MO 65401-4416 | 2019-08-28 |
1013479716 | Cerner Health Connections, Inc. | Pharmacy | 1403 Hampton Avenue, St. Louis, MO 63139 | 2019-04-02 |
Find all providers with the same taxonomy |
City | WENTZVILLE |
Zip Code | 63385 |
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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.