Organization
OKLAHOMA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 10101
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
101 E HALL OF FAME AVE, STILLWATER, OK 74075-5425
(405) 707-0287
Mailing address
ONE CVS DRIVE, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
OK
333600000X
Pharmacy
Primary
—
OK
3336C0003X
Community/Retail Pharmacy
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200113030V
—
OK
01
—
200113030W
DME
OK
01
—
3727003
NCPDP
OK
Enumeration date
08/31/2012
Last updated
06/05/2013
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