MEDICARE: CUDD COMPANY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WD0400X	Diabetes Educator Registered Nurse
2	261QM2500X	Medical Specialty Clinic/Center
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
5	333600000X	Pharmacy
6	3336C0004X	Compounding Pharmacy
7	3336L0003X	Long Term Care Pharmacy
8	3336S0011X	Specialty Pharmacy
9	3336C0003X	Community/Retail Pharmacy	1-7168	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2151527	OTHER	PK

General Provider Information

NPI Number	:	1841384252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUDD COMPANY LLC

Provider Business Mailing Address
First Line	:	3401 N MAY AVE STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6953
Country	:	US
Telephone Number	:	405-843-6691
Fax Number	:	405-848-3591

Provider Business Practice Location Address
First Line	:	3401 N MAY AVE STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6904
Country	:	US
Telephone Number	:	405-843-6691
Fax Number	:	405-848-3591

Authorized Official
Title or Position	:	CEO
Name	:	LAURA ANNETTE CUDD
Credential	:
Telephone Number	:	405-570-9496

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	12/09/2021

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Directions to “CUDD COMPANY LLC ” Practice Location

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