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CVS PHARMACY #05635
NPI 1205935517
Pharmacy in Kansas City, MO

Active since September 22, 2006CLIA 26D2225274 · Waiver
11124 HOLMES RD, KANSAS CITY, MO 64131(816) 942-3262(816) 942-7660 Get Directions Write a Review

NPPES record last updated: February 3, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cvs Pharmacy #05635 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #05635 (NPI 1205935517) is a healthcare organization registered as a pharmacy in Kansas City, Missouri and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through May 19, 2027 and lists Cristiana Mauricio, Mgr Phcy Enrollments, as its authorized official.

NPPES Registry Identity

NPI1205935517
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameMISSOURI CVS PHARMACY, L.L.C.
Location Address11124 HOLMES RDKansas City, MO 64131-3625
Mailing Address1 Cvs Dr, Po Box 1075Woonsocket, RI 02895-6146
Phone(816) 942-3262
Fax(816) 942-7660
Organization SubpartNo
Authorized OfficialCristiana MauricioMgr Phcy Enrollments · (401) 770-2937
Enumeration DateSeptember 22, 2006
Last NPPES UpdateFebruary 3, 2015
✔ NPI 1205935517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in MO · 2004023152
Definition
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.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
11124 HOLMES RD, Kansas City, MO 64131
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Other Names 1

Doing Business AsCvs Pharmacy #05635

Other Identifiers 5

Medicare PINP00754562
Medicaid603931205MO
Other2632114Other Id Number-commercial Number
Medicare NSC5724300033
Medicare PIN9004340

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2225274

Missouri CVS Pharmacy, LLC Dba Cvs/Pharmacy #05635 · Kansas City, MO
Active · expires May 19, 2027
CLIA Number26D2225274
Laboratory TypePharmacy
Certificate Effective DateMay 20, 2025
Certificate Expiration DateMay 19, 2027
Laboratory DirectorKristin Marx
Laboratory Phone(866) 389-2727
Laboratory LocationMissouri CVS Pharmacy, LLC Dba Cvs/Pharmacy #0563511124 Holmes Rd, Kansas City, MO 64131
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
198 services197 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
164 services164 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
29 services29 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #05635 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #05635

DMEPOS supplier · Kansas City, MOOperated by Missouri CVS Pharmacy LLC
✔

Accepts Medicare assignment

CVS Pharmacy #05635 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20324213
Medicare Participant SinceJanuary 1, 2023
Supplier Location11124 Holmes RdKansas City, MO 64131
Phone(816) 942-3262
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BINITA J PATEL
Pharmacist
11124 HOLMES RD
KANSAS CITY, MO 64131
Jackson County (816) 942-3262
MATTHEW ROBERT GRAHAM PHARMD
Pharmacist
11124 HOLMES RD
KANSAS CITY, MO 64131
Jackson County (816) 942-3262
FRANCIS KINYANJUI
Pharmacist
11124 HOLMES RD
KANSAS CITY, MO 64131
Jackson County (816) 942-3262

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Missouri CVS Pharmacy, L.L.C.'s NPI number?

The NPI number for Missouri CVS Pharmacy, L.L.C. is 1205935517. It was assigned to this organization in the NPPES registry on September 22, 2006. The provider is doing business as CVS Pharmacy #05635.

Where is Missouri CVS Pharmacy, L.L.C. located?

Missouri CVS Pharmacy, L.L.C. is located at 11124 Holmes Rd, Kansas City, MO 64131. The listed phone number is (816) 942-3262.

What is Missouri CVS Pharmacy, L.L.C.'s specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Missouri CVS Pharmacy, L.L.C. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #05635 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Missouri CVS Pharmacy, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2225274) is associated with this NPI, valid through May 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Missouri CVS Pharmacy, L.L.C. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 36 other insurers list Missouri CVS Pharmacy, L.L.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Missouri CVS Pharmacy, L.L.C. was last updated on February 3, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.