MISSOURI CVS PHARMACY LLC (NPI# 1194767384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194767384 |
| Entity Type | Organization |
| Organization Name | MISSOURI CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #16228 |
| Practice Address |
735 W Stadium Blvd Jefferson City MO 65109-4753 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5738931079 |
| Practice Fax Number | 5736589385 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2016-11-21 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2006020283 | MO | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2049266 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16228 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902437460 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6211 Delmar Blvd, Saint Louis, MO 63130-4814 | 2020-02-03 |
| 1699133678 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3320 North Belt Highway, St Joseph, MO 64506 | 2016-02-04 |
| 1811365257 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1589 Bryan Rd, O'fallon, MO 63366-3709 | 2015-09-02 |
| 1003282138 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 200 Jungermann Rd, Saint Peters, MO 63376-5347 | 2015-08-12 |
| 1104205749 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 101 E Karsch Blvd, Farmington, MO 63640-1235 | 2015-05-28 |
| 1619371077 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2120 W Osage St, Pacific, MO 63069-1101 | 2014-10-14 |
| 1427458496 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1550 S New Florissant Rd, Florissant, MO 63031-8123 | 2014-08-27 |
| 1427466408 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 112 E 32nd St, Joplin, MO 64804-3801 | 2014-07-23 |
| 1487060570 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2100 1st Capitol Dr, St. Charles, MO 63301 | 2014-07-09 |
| 1003230335 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8021 Watson Rd, Webster Groves, MO 63119-5304 | 2014-02-06 |
| Street Address |
735 W STADIUM BLVD |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-4753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811306913 | Skander Yalaoui | Pharmacist | 735 W Stadium Blvd, Jefferson City, MO 65109-4753 | 2014-08-04 |
| 1427396860 | Emily D Furlong | Pharmacist | 735 W Stadium Blvd, Jefferson City, MO 65109-4753 | 2013-01-18 |
| 1992072078 | Keith James Dahler | Pharmacist | 735 W Stadium Blvd, Jefferson City, MO 65109-4753 | 2011-11-17 |
| 1023302288 | Jennifer Lee Colozza | Pharmacist | 735 W Stadium Blvd, T-0752, Jefferson City, MO 65109-4753 | 2011-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982770640 | Whaleys Pharmacy Inc | Pharmacy | 3526 Amazonas Dr, Jefferson City, MO 65109-5716 | 2006-11-27 |
| 1427132554 | Whaleys Pharmacy Inc | Pharmacy | 630 E High St, Jefferson City, MO 65101-3219 | 2006-10-25 |
| 1013431675 | Old Town Apothecary, LLC | Pharmacy | 1739 Elm Ct Ste 108, Jefferson City, MO 65101-4303 | 2017-07-26 |
| 1174882864 | Capital Region Medical Center | Pharmacy | 1125 Madison St, Jefferson City, MO 65101-5227 | 2012-05-15 |
| 1336223460 | Whaleys Pharmacy Inc | Pharmacy | 1431 Southwest Blvd, Jefferson City, MO 65109-2491 | 2006-10-25 |
| 1568546307 | Whaleys Pharmacy Inc | Pharmacy | 1431 Southwest Blvd, Jefferson City, MO 65109-2468 | 2006-10-25 |
| 1326079443 | Kmart Operations LLC | Pharmacy | 2304 Missouri Blvd, Jefferson City, MO 65109-4729 | 2006-07-06 |
| 1841261153 | Jcmg Ancillary Services, LLC | Pharmacy | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912506437 | E Health Pharmacy, LLC | Pharmacy | 411d Northview Rd, Nixa, MO 65714-8679 | 2020-10-26 |
| 1750994869 | Script Partner Pharmacy LLC | Pharmacy | 100 Chesterfield Bus Pkwy Ste 279, Chesterfield, MO 63005-1271 | 2020-08-28 |
| 1821600545 | Debbie S Pharmacy LLC | Pharmacy | 815 Hazelwest Dr Ste 100, Hazelwood, MO 63042-1762 | 2020-08-24 |
| 1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
| 1023626389 | Lemonaid Community Pharmacy, Inc | Pharmacy | 7580 Watson Rd, Saint Louis, MO 63119-4409 | 2020-07-22 |
| 1689207870 | Washington University Cancer Center Pharmacy - North County | Pharmacy | 1225 Graham Rd Fl 1, Florissant, MO 63031-8012 | 2020-02-17 |
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1720624323 | Toney Drug & Wellness, LLC | Pharmacy | #1 Hals Plaza Dr, Piedmont, MO 63957 | 2019-11-19 |
| 1427606912 | Medley Pharmacy Inc | Pharmacy | 1024 S Bishop Ave, Rolla, MO 65401-4416 | 2019-08-28 |
| 1013479716 | Cerner Health Connections, Inc. | Pharmacy | 1403 Hampton Avenue, St. Louis, MO 63139 | 2019-04-02 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.