MISSOURI CVS PHARMACY, L.L.C. (NPI# 1629035084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629035084 |
| Entity Type | Organization |
| Organization Name | MISSOURI CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #11314 |
| Practice Address |
1105 N Rutherford St Macon MO 63552 |
| Mailing Address |
1 Cvs Drive Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6603852147 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 6608866320 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2018-09-06 |
| 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 |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #11314 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629553474 | Missouri Cvs Pharmacy, L.L.C. | Pharmacy | 60 Harvester Sq, St. Charles, MO 63303-6357 | 2018-09-27 |
| 1568947315 | Missouri Cvs Pharmacy, L.L.C. | Registered Nurse | 2183 Charbonier Rd, Florissant, MO 63031-5500 | 2018-09-27 |
| 1467937201 | Missouri Cvs Pharmacy, L.L.C. | Registered Nurse | 9070 St. Charles Rock Rd, St. Louis, MO 63114-4246 | 2018-09-27 |
| 1356826200 | Missouri Cvs Pharmacy, L.L.C. | Registered Nurse | 500 Us Highway 50 W, Union, MO 63084-1938 | 2018-09-26 |
| 1093163792 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 696-698 North Hwy 67 St., Florissant, MO 63031-5106 | 2016-06-03 |
| 1407251069 | Missouri Cvs Pharmacy, L.L.C. | Clinic/Center | 942 Valley Creek Dr, Farmington, MO 63640-1968 | 2014-10-24 |
| 1386059533 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 320 E Lexington St, Richmond, MO 64085 | 2014-06-26 |
| 1205189024 | Missouri Cvs Pharmacy, L.L.C. | Registered Nurse | 2511 Kehrs Mill Rd, Chesterfield, MO 63017-7358 | 2012-10-17 |
| 1255649026 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 4100 Gravois Ave, Saint Louis, MO 63116-3520 | 2010-09-15 |
| 1285940957 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 11560 Olive Blvd, Creve Coeur, MO 63141 | 2010-08-19 |
| Street Address |
1105 N RUTHERFORD ST |
| City | MACON |
| State | MO |
| Zip Code | 63552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891194783 | Dialysis Clinic Inc | Clinic/Center | 1203 N. Missouri St, Macon, MO 63552 | 2014-08-18 |
| 1477624161 | Charles Edgar Averill Jr. | Occupational Therapist | 704a South Missouri, Macon, MO 63552 | 2006-11-13 |
| 1659560688 | Iris Ladawn Gaerditz | Speech-Language Pathologist | 702 N Missouri St, Macon, MO 63552 | 2007-10-16 |
| 1841316296 | Paul Vincent Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-03-21 |
| 1891908612 | Mid Missouri Physical Therapy | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-05-08 |
| 1366568735 | Lara Beth Jones | Physical Therapist | 2005 N. Missouri St., Suite D., Macon, MO 63552-0381 | 2007-03-21 |
| 1871619262 | Abby M Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0387 | 2007-03-21 |
| 1457715906 | Kimberly Oroke | Social Worker | 821 Charles St, Columbia, MO 63552-1064 | 2016-04-11 |
| 1679100507 | Macon County Sheltered Workshop | Private Vehicle | 1103 Enterprise Rd, Macon, MO 63552-1305 | 2020-03-23 |
| 1538270384 | James A Wilson | Dentist | 509 S Missouri St, Macon, MO 63552-1338 | 2006-08-31 |
| Find all providers in zip 63552 | ||||
| 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 |
|---|---|---|---|---|
| 1720603756 | Medical-pharmacy Associates of Georgia, LLC | Pharmacy | 1425 Georgia Ave Ste 1, Macon, GA 31201-6546 | 2020-06-16 |
| 1730632829 | Pharmscript of Ga LLC | Pharmacy | 4611 Ivey Dr Ste 850, Macon, GA 31206-8819 | 2016-07-26 |
| 1750747622 | Cardinal Health Pharmacy Services LLC | Pharmacy | 770 Walnut St Ste 100, Macon, GA 31201-7307 | 2016-01-08 |
| 1093087090 | M&e Pharmacy Services Inc | Pharmacy | 1193 Forsyth St, Macon, GA 31201-1735 | 2012-02-07 |
| 1760511547 | Chichesters Ingleside | Pharmacy | 3051 Vineville Ave, Macon, GA 31204-2460 | 2007-03-05 |
| 1326110107 | Unionville Discount Pharmacy Inc | Pharmacy | 1381 Pio Nono Ave, Macon, GA 31204-4633 | 2006-11-15 |
| 1366551624 | Central Georgia Cancer Care PC | Pharmacy | 800 1st St Ste 415, Macon, GA 31201-8300 | 2006-08-30 |
| 1841216413 | Freds Stores of Tennessee Inc | Pharmacy | 59 Frontage Rd, Macon, MS 39341 | 2006-07-15 |
| 1104858133 | Freds Stores of Tennessee Inc | Pharmacy | 1540 Eisenhower Pkwy, Macon, GA 31206-3153 | 2006-07-07 |
| 1003884255 | Bws Major Management Systems | Pharmacy | 635 Pio Nono Ave, Macon, GA 31204-3531 | 2006-03-12 |
| Find all providers in MACON | ||||
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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.