NPIMap

Organization Active NPI

Missouri CVS Pharmacy LLC

Doing business as CVS Pharmacy #16385

  • Pharmacy
  • Cape Girardeau, MO
National Provider Identifier
1972685345
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MISSOURI CVS PHARMACY LLC
Doing business as
CVS Pharmacy #16385
Practice address
202 Siemens Dr
Cape Girardeau, MO 63701
Phone
(573) 334-6578
Fax
(573) 290-3566
NPI assigned
Oct 19, 2006
Last updated
Nov 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Authorized official

Name
Susan Colbert
Title
Sr. Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU Primary
Community/Retail Pharmacy 3336C0003X 2006029584 MO

Addresses

Primary practice location

202 Siemens Dr
Cape Girardeau, MO 63701

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 1

IdentifierTypeStateIssuer
2049280OtherPK

Other names 1

  • CVS Pharmacy #16385 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061106000551 MO Part B Supplier - Mass Immunization (Roster Biller Only) 3577560499 This NPI is an additional NPI on the enrollment
O20161027000162 MO DME Supplier - Pharmacy 3577560499 Practice locations: Cape Girardeau, MO

National Provider Directory

National Provider Directory
Tax ID family
Missouri CVS Pharmacy LLC196 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

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": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1972685345",
    "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",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 SIEMENS DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63701",
            "telephone_number": "573-334-6578",
            "fax_number": "573-290-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "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": "MO",
            "license": "2006029584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049280",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #16385",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.