NPIMap

Organization Active NPI

Kansas CVS Pharmacy, L.L.C.

  • Pharmacy
  • Olathe, KS
National Provider Identifier
1972607828
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2-09932 Issued in KS
Legal business name
KANSAS CVS PHARMACY, L.L.C.
Practice address
1785 S Mur Len Rd
Olathe, KS 66062-2611
Phone
(913) 390-9892
Fax
(913) 390-9523
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Cristiana Mauricio
Title
MGR Phcy Enrollments
Phone
(401) 770-2937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 2-09932 KS Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1785 S Mur Len Rd
Olathe, KS 66062-2611

Mailing address

1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146

Other identifiers 2

IdentifierTypeStateIssuer
1717909OtherOTHER ID NUMBER-COMMERCIAL NUMBER
200602180DMedicaidKS

Other names 1

  • CVS PHARMACY # 05257 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
O20100930072546 KS DME Supplier - Pharmacy 4082619721 Practice locations: Olathe, 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
17D2185891Kansas CVS Pharmacy, L.L.C.1785 South Mur-Len Road, Olathe, KS 66062Certificate of waiverJun 10, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #052571785 S Mur Len Rd, Olathe, KS 66062-2611(913) 390-9892 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

1785 S Mur Len Rd
Olathe, KS 66062
Phone (913) 390-9892

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1972607828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "PO BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 S MUR LEN RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660622611",
            "telephone_number": "913-390-9892",
            "fax_number": "913-390-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS CVS PHARMACY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "CRISTIANA",
        "authorized_official_title_or_position": "MGR PHCY ENROLLMENTS",
        "authorized_official_telephone_number": "401-770-2937"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KS",
            "license": "2-09932",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1717909",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200602180D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY # 05257",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.