Missouri Cvs Pharmacy LLC

NPI #1902144306 in Nixa, Missouri

Provider Information

NPI Number: 1902144306
Entity Type: Organization
Organization Name: Missouri Cvs Pharmacy LLC
Primary Specialty: Pharmacy
Enumeration Date: Jan 21, 2013
Last Updated: Jun 18, 2013

Practice Location

Address: 501 W MOUNT VERNON ST
City: Nixa
State: Missouri
ZIP Code: 65714-9661
Phone: (417) 724-8409

Authorized Official

Name: SUSAN COLBERT
Title: DIRECTOR
Phone: (401) 765-1500

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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