Organization
OKLAHOMA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 06009
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
5025 N MAY AVE, OKLAHOMA CITY, OK 73112-6040
(405) 947-6743
(405) 948-6125
Mailing address
1 CVS DR, PO BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
1-5380
OK
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100234810A
—
OK
01
—
100234810B
MEDICAID - DME
OK
01
—
3702607
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
10/19/2011
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