Organization
OKLAHOMA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #10102
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
930 WEST GARRIOTT RD, ENID, OK 73701-5440
(580) 234-5192
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200113030X
—
OK
01
—
200113030Y
DME
OK
01
—
3727837
NCPDP
OK
Enumeration date
01/14/2014
Last updated
07/15/2014
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