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MISSOURI CVS PHARMACY LLC NPI 1578997631


NPI Information

NPI: 1578997631
Provider Name: MISSOURI CVS PHARMACY LLC

Doing Business As: CVS PHARMACY #10280

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 26D2282506

Address:
500 N BISHOP AVE
ROLLA, MO
ZIP 65401
Phone: (573) 308-4887
Get Directions

MISSOURI CVS PHARMACY LLC is a pharmacy in Rolla, MO. The provider is 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. MISSOURI CVS PHARMACY LLC NPI is 1578997631. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #10280.

The provider's business location address is:

500 N BISHOP AVE
ROLLA, MO
ZIP 65401-989
Phone: (573) 308-4887

The provider's authorized official is Susan Colbert .
The authorized official title is Director and has the following contact phone number (401) 765-1500.

The CLIA number assigned to this NPI record is 26D2282506 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/26/2013 and was last updated on 11/7/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15724300075MEDICARE NSC
21578997631MEDICAIDMISSOURI
32641391OTHERNCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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