Organization
OKLAHOMA CVS PHARMACY LLC
Active
Other names
CVS PHARMACY #10214
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
511 S ELM ST, JENKS, OK 74037-3700
(918) 298-4428
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
—
100233690I
—
OK
01
—
100233690R
DME
OK
01
—
3727306
NCPDP
OK
Enumeration date
05/15/2013
Last updated
07/02/2014
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