National Provider Identifier Database

OKLAHOMA CVS PHARMACY LLC
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

OKLAHOMA CVS PHARMACY LLC
751 W TUSCAN ST
121ST
BROKEN ARROW, OK74011
Phone: 918-455-0089
Fax: 918-455-0024
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X

* Indicates primary specialty

NPI Profile & details for OKLAHOMA CVS PHARMACY LLC

NPI Number 1942524061
Legal business name
LBN
OKLAHOMA CVS PHARMACY LLC
Authorized official SUSAN COLBERT - (DIRECTOR, PAYER RELATIONS)
Entity Organization
Organization subpart No
Enumeration date 03/18/2010
Last updated 11/08/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • OK Medicaid: 200288170A
  • Other: 3726138 NCPDP
  • OK Other: 200288180A MEDICAID DME

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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