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CVS PHARMACY #04536
NPI 1255647541
Pharmacy in Booneville, MS

Active since August 24, 2010CLIA 25D2262562 · Waiver
301 AMERICAN AVE, BOONEVILLE, MS 38829(662) 720-1707 Get Directions Write a Review

NPPES record last updated: January 17, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cvs Pharmacy #04536 NPPES

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

CVS PHARMACY #04536 (NPI 1255647541) is a healthcare organization registered as a pharmacy in Booneville, Mississippi and active in the NPI registry since August 2010. The organization holds a CLIA Waiver certificate valid through June 14, 2028 and lists Susan Colbert, Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1255647541
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameMISSISSIPPI CVS PHARMACY, L.L.C.
Location Address301 AMERICAN AVEBooneville, MS 38829-1001
Mailing Address1 Cvs Dr, Box 1075-pharmacy EnrollmentsWoonsocket, RI 02895-6146 · (401) 765-1500
Phone(662) 720-1707
Organization SubpartNo
Authorized OfficialSusan ColbertDirector, Payer Relations · (401) 770-2751
Enumeration DateAugust 24, 2010
Last NPPES UpdateJanuary 17, 2023
NPPES CertifiedJanuary 17, 2023
✔ NPI 1255647541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
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 ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
301 AMERICAN AVE, Booneville, MS 38829
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Other Names 1

Doing Business AsCvs Pharmacy #04536

Other Identifiers 3

Other2588119Ncpdp
Other07609070MS · Medicaid Dme
Medicaid01880069MS

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 25D2262562

Mississippi CVS Pharmacy LLC Dba CVS Pharmacy04536 · Booneville, MS
Active · expires Jun 14, 2028
CLIA Number25D2262562
Laboratory TypePharmacy
Certificate Effective DateJune 15, 2026
Certificate Expiration DateJune 14, 2028
Laboratory DirectorAmanda Stricklen
Laboratory Phone(601) 720-1707
Laboratory LocationMississippi CVS Pharmacy LLC Dba CVS Pharmacy04536301 American Avenue, Booneville, MS 38829
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

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.
180 services177 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.
133 services133 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
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
20 services20 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
20 services20 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #04536 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #04536

DMEPOS supplier · Booneville, MSOperated by Mississippi CVS Pharmacy LLC
⋮

Does not accept Medicare assignment

CVS Pharmacy #04536 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20447033
Medicare Participant SinceJanuary 1, 2019
Supplier Location301 American AveBooneville, MS 38829
Phone(662) 720-1707
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 2

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

AMY LOWREY SKINNER PHARMD
Pharmacist
301 AMERICAN AVE
BOONEVILLE, MS 38829
Prentiss County (662) 720-1707
DR. AMANDA D STRICKLEN PHARMD
Pharmacist
301 AMERICAN AVE
BOONEVILLE, MS 38829
Prentiss County (662) 720-1707

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 Mississippi CVS Pharmacy, L.L.C.'s NPI number?

The NPI number for Mississippi CVS Pharmacy, L.L.C. is 1255647541. It was assigned to this organization in the NPPES registry on August 24, 2010. The provider is doing business as CVS Pharmacy #04536.

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

Mississippi CVS Pharmacy, L.L.C. is located at 301 American Ave, Booneville, MS 38829. The listed phone number is (662) 720-1707.

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

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

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

No. As a Medicare medical equipment supplier, CVS Pharmacy #04536 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

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

Yes. A Certificate of Waiver (number 25D2262562) is associated with this NPI, valid through June 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mississippi 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 38 other insurers list Mississippi 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 Mississippi CVS Pharmacy, L.L.C. was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.