Missouri CVS Pharmacy LLC
NPI 1104205749ActiveOrganization· Pharmacy· Farmington, MO
Pharmacy in Farmington, Missouri, registered in NPPES in May 2015. The authorized official on file is Susan Colbert, Director. Medicare paid $37,027 for services to 147 patients in 2024.
Overview
| NPI | 1104205749 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 28, 2015 |
| Last updated in NPPES | Oct 29, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (MO) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 147 |
|---|---|
| Services billed | 478 across 12 procedure codes |
| Paid by Medicare | $37,027 |
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