Organization
OKLAHOMA CVS PHARMACY, L.L.C.
Active
Other names
CVS Pharmacy # 02324
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
12902 E 96TH ST N, OWASSO, OK 74055-4778
(918) 272-2376
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
—
OK
333600000X
Pharmacy
Primary
—
OK
3336C0003X
Community/Retail Pharmacy
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200113030P
—
OK
01
—
200113030Q
MEDICAID DME
OK
01
—
3726354
NCPDP
—
Enumeration date
09/08/2010
Last updated
03/08/2012
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