OKLAHOMA CVS PHARMACY LLC (NPI# 1073817185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073817185 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #04896 |
| Practice Address |
1853 S Aspen Ave Broken Arrow OK 74012-5104 |
| Mailing Address |
1 Cvs Dr Box 1075-pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 9182519615 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2011-05-17 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | MEDICAID DME | 100233690E | 01 |
| NCPDP | 3726467 | 01 | |
| OK | 100233690F | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #04896 | 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 |
| 1023452851 | Oklahoma Cvs Pharmacy LLC | Pharmacy | 2030 Nw 82nd St, Lawton, OK 73505-2355 | 2013-04-23 |
| 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 |
| Street Address |
1853 S ASPEN AVE |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-5104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| 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 |
|---|---|---|---|---|
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1336663699 | Cpii, LLC | Pharmacy | 811 W. New Orleans, Ste 101, Broken Arrow, OK 74011 | 2017-07-28 |
| 1336502186 | Genoa Healthcare, LLC | Pharmacy | 8937 S Garnett Rd Ste P, Broken Arrow, OK 74012-6004 | 2016-03-30 |
| 1427132182 | Mays Drug Stores In | Pharmacy | 4900 W Kenosha St, Broken Arrow, OK 74012-8517 | 2006-10-25 |
| 1013958990 | Tcaacp LLC | Pharmacy | 511 S Aspen Ave, Broken Arrow, OK 74012-2296 | 2006-06-09 |
| 1518904945 | Albertsons LLC | Pharmacy | 3612 S Elm Pl, Broken Arrow, OK 74011-1801 | 2006-06-02 |
| 1417994849 | Albertsons LLC | Pharmacy | 2420 E Kenosha St, Broken Arrow, OK 74014-6718 | 2006-06-02 |
| 1902985047 | Mays Drug Stores Inc | Pharmacy | 626 W New Orleans St, Broken Arrow, OK 74011-2212 | 2006-11-02 |
| 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 |
| 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 |
| 1255855854 | Okc Scripts LLC | Pharmacy | 5914 Nw 38th St # 5914, Warr Acres, OK 73122-2008 | 2017-07-26 |
| 1639611403 | Saint Francis Pharmacy Services | Pharmacy | 6161 S Yale B Level Blue North, Tulsa, OK 74136 | 2016-11-10 |
| 1780040675 | Convenient Rx | Pharmacy | 5272 S Lewis Ave Ste 240, Tulsa, OK 74105-6568 | 2016-01-07 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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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.