NPIMap

Organization Active NPI

Kansas CVS Pharmacy, L.L.C

Doing business as Cvs Pharmacy #10862

  • Pharmacy
  • Gardner, KS
National Provider Identifier
1962914838
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
KANSAS CVS PHARMACY, L.L.C
Doing business as
Cvs Pharmacy #10862
Practice address
110 W Main St
Gardner, KS 66030-1106
Phone
(401) 765-1500
NPI assigned
Oct 31, 2017
Last updated
Oct 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan F Colbert
Title
Sr. Director Payer Relations
Phone
(401) 765-1500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

110 W Main St
Gardner, KS 66030-1106

Mailing address

1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other names 1

  • Cvs Pharmacy #10862 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061002000208 KS Part B Supplier - Mass Immunization (Roster Biller Only) 4082619721 This NPI is an additional NPI on the enrollment
O20180403002273 KS DME Supplier - Pharmacy 4082619721 Practice locations: Gardner, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2225740Kansas CVS Pharmacy, LLC110 West Main St, Gardner, KS 66030Certificate of waiverMay 23, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #10862110 W Main St, Gardner, KS 66030-1106(913) 856-0280 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 assignmentParticipating since Jan 1, 2025

National Provider Directory

National Provider Directory
Tax ID family
Kansas CVS Pharmacy LLC48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 71)

400 S 10th St
Atchison, KS 66002
Phone (913) 367-1518

400 S 10th St
#5889
Atchison, KS 66002
Phone (913) 367-1518

2024 N Rock Rd
#17502
Derby, KS 67037
Phone (316) 448-4554

1215 Merchant St
#10294
Emporia, KS 66801
Phone (620) 340-0121

110 W Main St
Gardner, KS 66030
Phone (913) 856-0280

203 S Washington St
#10304
Junction City, KS 66441
Phone (785) 223-0781

10900 Stadium Pkwy
#17299
Kansas City, KS 66111
Phone (913) 905-0317

3750 State Ave
#8603
Kansas City, KS 66102
Phone (913) 281-3551

4300 Rainbow Blvd
#8919
Kansas City, KS 66103
Phone (913) 403-0581

4645 Shawnee Dr
#8608
Kansas City, KS 66106
Phone (913) 236-4000

8101 State Ave
#8600
Kansas City, KS 66112
Phone (913) 299-1020

950 Minnesota Ave
#8584
Kansas City, KS 66101
Phone (913) 321-4505

2300 Iowa St
Lawrence, KS 66046
Phone (785) 209-0156

2300 Iowa St
#676
Lawrence, KS 66046
Phone (785) 832-1112

3201 S Iowa St
#16147
Lawrence, KS 66046
Phone (785) 832-0312

4841 Bauer Farm Dr
Lawrence, KS 66049
Phone (785) 840-9381

4841 Bauer Farm Dr
#3212
Lawrence, KS 66049
Phone (785) 840-9381

390 Limit St
#5268
Leavenworth, KS 66048
Phone (913) 651-2323

11729 Roe Ave
#8588
Leawood, KS 66211
Phone (913) 345-8404

5001 W 135th St
Leawood, KS 66224
Phone (913) 851-9903

5001 W 135th St
#8237
Leawood, KS 66224
Phone (913) 851-9903

10050 Woodland Rd
Lenexa, KS 66220
Phone (913) 397-0906

10050 Woodland Rd
#4323
Lenexa, KS 66220
Phone (913) 397-0906

13502 W 87th Street Pkwy
Lenexa, KS 66215
Phone (913) 492-4650

14950 W 87th Street Pkwy
Lenexa, KS 66215
Phone (913) 888-2538

Practitioners & affiliated clinicians

Practitioners 84

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 84

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1962914838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MAIN ST",
            "city": "GARDNER",
            "state": "KS",
            "postal_code": "660301106",
            "telephone_number": "401-765-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS CVS PHARMACY, L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR. DIRECTOR PAYER RELATIONS",
        "authorized_official_telephone_number": "401-765-1500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cvs Pharmacy #10862",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardner, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.

Verify at the official NPI Registry.