Missouri CVS Pharmacy LLC
NPI 1194767384ActiveOrganization· Pharmacy· Jefferson City, MO
Pharmacy in Jefferson City, Missouri, registered in NPPES in June 2006. The authorized official on file is Susan Colbert, Sr. Director, Payer Relations. Medicare paid $31,258 for services to 144 patients in 2024.
Overview
| NPI | 1194767384 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 12, 2006 |
| Last updated in NPPES | Nov 21, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | 2006020283 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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 | 144 |
|---|---|
| Services billed | 416 across 10 procedure codes |
| Paid by Medicare | $31,258 |
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