Organization
OKLAHOMA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 06222
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1220 N COMMERCE ST, ARDMORE, OK 73401
(580) 223-1041
(580) 226-9757
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
12-4992
OK
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3717634
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
90003924255
—
OK
Enumeration date
09/12/2006
Last updated
11/07/2014
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