Healthcare Provider Details

I. General information

NPI: 1467098806
Provider Name (Legal Business Name): CUDD COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N MAY AVE STE B
OKLAHOMA CITY OK
73112-6953
US

IV. Provider business mailing address

3401 N MAY AVE STE B
OKLAHOMA CITY OK
73112-6953
US

V. Phone/Fax

Practice location:
  • Phone: 405-843-6691
  • Fax: 405-848-3591
Mailing address:
  • Phone: 405-843-6691
  • Fax: 405-848-3591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LAURA ANNETTE CUDD
Title or Position: CEO
Credential: DPH, PHD
Phone: 405-570-9496