MISSOURI CVS PHARMACY LLC (NPI# 1649548330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649548330 |
| Entity Type | Organization |
| Organization Name | MISSOURI CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #04080 |
| Practice Address |
300 Kestrel Lane Lake Ozark MO 65065 |
| Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 5733657298 |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2012-08-02 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 2639928 | 01 | |
| MO | DME | 1649548330 | 01 |
| MO | 1649548330 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #04080 | 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 |
300 KESTREL LANE |
| City | LAKE OZARK |
| State | MO |
| Zip Code | 65065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778859 | Suzanne Marie Harris | Social Worker | 1191 State Highway Kk, Suite 101, Osage Beach, MO 65065 | 2020-04-15 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1245723337 | William T Mcfail | Counselor | 1191 State Hwy Kk, Suite 101, Osage Beach, MO 65065 | 2018-06-13 |
| 1588102263 | Jennifer Kiske | Physical Therapist | 5780 Osage Beach Parkway, Ste 220, Osage Beach, MO 65065 | 2017-02-02 |
| 1700207586 | Brenda Renee Spies | Pharmacist | 4252 Osage Beach Parkway, Osage Beach, MO 65065 | 2013-12-23 |
| 1154668465 | Paige Hedgpath Od, PC | Optometrist | 4645g Osage Beach Parkway, Osage Beach, MO 65065 | 2013-01-07 |
| 1437399821 | Melissa Nicole Morgan | Physical Therapy Assistant | 5177 Vicus Castri, Osage Beach, MO 65065 | 2009-02-25 |
| 1730330911 | Raymond Don Baker | Preventive Medicine | 5476 Stone Ledge Cir, Osage Beach, MO 65065 | 2008-10-06 |
| 1457514259 | Lake Family Dentistry | Dentist | 1037 Palisades Blvd Ste 9, Osage Beach, MO 65065 | 2008-07-02 |
| 1356503494 | Erin Christine Gagnon | Optometrist | 4645 G Osage Beach Parkway, Osage Beach, MO 65065 | 2008-06-30 |
| Find all providers in zip 65065 | ||||
| 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 |
|---|---|---|---|---|
| 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 | LAKE OZARK |
| Zip Code | 65065 |
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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.