OKLAHOMA CVS PHARMACY LLC (NPI# 1023452851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023452851 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #17612 |
| Practice Address |
2030 Nw 82nd St Lawton OK 73505-2355 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5083547275 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2016-10-25 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
3-7628 | OK | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2139914 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17612 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1407278260 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 930 West Garriott Rd, Enid, OK 73701-5440 | 2014-01-14 |
| 1295156966 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 100 N. Jm Davis Blvd, Claremore, OK 74017-6811 | 2013-12-26 |
| 1487088191 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1250 W Main St, Durant, OK 74701-4932 | 2013-08-29 |
| 1184060048 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 9122 S Yale Ave, Tulsa, OK 74137-4039 | 2013-05-20 |
| 1629414859 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 511 S Elm St, Jenks, OK 74037-3700 | 2013-05-15 |
| 1093159774 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 251 S Hwy 97, Sand Springs, OK 74063-6521 | 2013-04-24 |
| 1427307776 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 101 E Hall of Fame Ave, Stillwater, OK 74075-5425 | 2012-08-31 |
| 1568756963 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 720 Sw 19th St, Moore, OK 73160-2941 | 2011-06-02 |
| 1073817185 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1853 S Aspen Ave, Broken Arrow, OK 74012-5104 | 2011-01-04 |
| Street Address |
2030 NW 82ND ST |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-2355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811362882 | Eugene Janz | Pharmacist | 2030 Nw 82nd St, Lawton, OK 73505-2355 | 2015-12-02 |
| 1023440849 | Mark Raymond Guinup Jr. | Pharmacist | 2030 Nw 82nd St, T-2739, Lawton, OK 73505-2355 | 2013-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942366430 | 1st Pharmacy Corp | Pharmacy | 2702 W. Gore Blvd., Lawton, OK 73505 | 2006-12-29 |
| 1952952566 | Comanche County Hospital Authority | Pharmacy | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2019-09-25 |
| 1902063902 | State of Oklahoma | Pharmacy | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2008-05-19 |
| 1801961743 | Quantum Medical Inc | Pharmacy | 4202 Sw Lee Blvd, Bldg B, Ste 204a, Lawton, OK 73505-8300 | 2006-11-22 |
| 1124059191 | K Mart Corp | Pharmacy | 1050 Nw 38th St, Lawton, OK 73505-3704 | 2006-07-06 |
| 1598763005 | Dishman Pharmacy Inc | Pharmacy | 1310 Sw Lee Blvd, Lawton, OK 73501-5610 | 2005-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808625 | Bigbox Pharmacy Unlimited LLC | Pharmacy | 509 E Chestnut St Ste B, Hollis, OK 73550-2031 | 2020-07-08 |
| 1033736657 | Genscripts Glenpool, LLC | Pharmacy | 12100 South Yukon Avenue, Suite A, Glenpool, OK 74033 | 2020-06-30 |
| 1952923104 | Creek Nation Hospital & Clinics | Pharmacy | 31870 1/2 East Hwy 51, Coweta, OK 74429-7900 | 2020-05-11 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1225592496 | Crimson Spire Pharmacy | Pharmacy | 5600 S.e. 67 Str, Suite A, Okc, OK 73135 | 2019-01-22 |
| 1366945842 | Pharmore Specialty Pharmacies LLC | Pharmacy | 3330 Nw 56th St Ste 100, Oklahoma City, OK 73112-4426 | 2018-03-12 |
| 1295241867 | Mannford Pharmacy LLC | Pharmacy | 231 W Trower Blvd, Mannford, OK 74044 | 2017-12-19 |
| 1215448337 | 1st Choice Pharmacy | Pharmacy | 1147a W 15th St, Edmond, OK 73013-3008 | 2017-10-16 |
| 1336663699 | Cpii, LLC | Pharmacy | 811 W. New Orleans, Ste 101, Broken Arrow, OK 74011 | 2017-07-28 |
| 1255855854 | Okc Scripts LLC | Pharmacy | 5914 Nw 38th St # 5914, Warr Acres, OK 73122-2008 | 2017-07-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.