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NPI Code Detail

MEDICARE: OKLAHOMA CVS PHARMACY LLC

MEDICARE: OKLAHOMA CVS PHARMACY 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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical SuppliesOK
3333600000XPharmacy1-5379OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13702467OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962506790
Entity Type Code : Organization
Provider Name (Legal Business Name) : OKLAHOMA CVS PHARMACY LLC
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : PO BOX 1075
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number : 401-765-1500
Fax Number :
Provider Business Practice Location Address
First Line : 6951 SE 15TH ST
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-2748
Country : US
Telephone Number : 405-737-7886
Fax Number : 405-733-4354
Authorized Official
Title or Position : DIRECTOR, PAYER RELATIONS
Name : SUSAN F COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 09/12/2006
Last Update Date : 01/12/2015

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Directions to “OKLAHOMA CVS PHARMACY LLC ” Practice Location

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