Active NPI
Missouri CVS Pharmacy, L.L.C.
Doing business as CVS Pharmacy # 03087
- Pharmacy
- Creve Coeur, MO
National Provider Identifier
1285940957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- MISSOURI CVS PHARMACY, L.L.C.
- Doing business as
- CVS Pharmacy # 03087
- Practice address
- 11560 Olive Blvd
Creve Coeur, MO 63141 - Phone
- (314) 995-7128
- NPI assigned
- Aug 19, 2010
- Last updated
- Oct 31, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan F. Colbert
- Title
- Director
- Phone
- (401) 765-1500
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
11560 Olive Blvd
Creve Coeur, MO 63141
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285940957 | Medicaid | MO | |
| 2639233 | Other | NCPDP |
Other names 1
- CVS Pharmacy # 03087
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061106000551 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 3577560499 | This NPI is an additional NPI on the enrollment |
| O20110107000473 | MO | DME Supplier - Pharmacy | 3577560499 | Practice locations: Creve Coeur, MO |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #03087 | Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Missouri CVS Pharmacy LLC
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba CVS Pharmacy #18024
- Community/Retail Pharmacy
- Webster Groves, MO
- NPI 1215972237
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282176000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1383177600000",
"number": "1285940957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11560 OLIVE BLVD",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-995-7128"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MISSOURI CVS PHARMACY, L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2010-08-19",
"last_updated": "2013-10-31",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F.",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1285940957",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "2639233",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy # 03087",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Creve Coeur, MO
- Graeme Mindel, M.D.
- Lauren Minden
- Mindful Change STL LLC
- Minimed Distribution Corp.
- Carol Ruth Mischnick, M.D.
- Missouri Imaging Affiliates LLC (Clinical PET of West County)
- Missouri Pain Specialists, LLC
- Missouri Professional Staffing Service Home Health Inc
- Lauren L Mitchell, PTA
- Modern Vascular of St Louis LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.