Organization
OKLAHOMA CVS PHARMACY LLC
Active
Other names
CVS Pharmacy #17479
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1150 E HILLSIDE DR, BROKEN ARROW, OK 74012-2385
(918) 615-1901
(918) 615-1912
Mailing address
1 CVS DR, BOX 1075, 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
2-7624
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118398
PK
—
Enumeration date
02/02/2009
Last updated
11/08/2016
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