Healthcare Provider Details

I. General information

NPI: 1922102151
Provider Name (Legal Business Name): CARTER HEALTHCARE PHARMACY AND DME OF OKLAHOMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 COLTRANE PL STE 3
EDMOND OK
73034-6795
US

IV. Provider business mailing address

7725 W RENO AVE STE 332
OKLAHOMA CITY OK
73127-9799
US

V. Phone/Fax

Practice location:
  • Phone: 405-947-7700
  • Fax: 405-974-7300
Mailing address:
  • Phone: 405-947-7700
  • Fax: 405-974-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number1-4516
License Number StateOK

VIII. Authorized Official

Name: JUSTIN CARTER
Title or Position: AUTHORIZED OFFICIAL/PRESIDENT
Credential:
Phone: 405-947-7700