Missouri Cvs Pharmacy, L.l.c.

NPI #1104919810 in Fulton, Missouri

Provider Information

NPI Number: 1104919810
Entity Type: Organization
Organization Name: Missouri Cvs Pharmacy, L.l.c.
Primary Specialty: Pharmacy
Enumeration Date: Oct 2, 2006
Last Updated: Aug 31, 2018

Practice Location

Address: 600 COURT ST
City: Fulton
State: Missouri
ZIP Code: 65251-1903
Phone: (573) 642-6892

Authorized Official

Name: SUSAN COLBERT
Title: SR. DIRECTOR, PAYER RELATIONS
Phone: (401) 770-2751

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy	3336C0003X
Pharmacy	333600000X	Primary

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