BOULEVARD PHARMACY
NPI 1477638567
Pharmacy - Community/Retail Pharmacy in Bartlesville, OK

Active since October 26, 2006
1117 SE FRANK PHILLIPS BLVD, BARTLESVILLE, OK 74003(918) 336-2140(918) 336-2145 Get Directions Write a Review

NPPES record last updated: December 8, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 8, 2021, Aug 5, 2020 (2 updates tracked since 2020).

  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • Accepts Insurance

About BOULEVARD PHARMACY

This page provides the complete NPI Profile along with additional information for Boulevard Pharmacy, a provider established in Bartlesville, Oklahoma operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1477638567 assigned on October 2006. The practitioner's primary taxonomy code is 3336C0003X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Boulevard Pharmacy. The authorized official of this NPI record is Jacey Cole (Owner)

NPI
1477638567 Verify this NPI
Provider Legal Name
BOULEVARD PHARMACY INC
Other Organization Name
BOULEVARD PHARMACY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1117 SE FRANK PHILLIPS BLVD BARTLESVILLE, OK 74003
Location Phone
(918) 336-2140
Location Fax
(918) 336-2145
Mailing Address
1117 SE FRANK PHILLIPS BLVD BARTLESVILLE, OK 74003
Mailing Phone
(918) 336-2140
Mailing Fax
(918) 336-2145
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-26-2006
Last Update Date
12-08-2021
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
Taxonomy Description
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

 
2333600000XSuppliers

Pharmacy

 
33336C0004XSuppliers

Pharmacy
Compounding Pharmacy

 
43336L0003XSuppliers

Pharmacy
Long Term Care Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Select by Medica Bronze $0 Copay PCP Visits - EPO
  • Select by Medica Bronze Share - EPO
  • Select by Medica Expanded Bronze Standard - EPO
  • Select by Medica Gold $0 Copay PCP Visits - EPO
  • Select by Medica Gold Share - EPO
  • Select by Medica Gold Standard - EPO
  • Select by Medica Silver $0 Copay PCP Visits - EPO
  • Select by Medica Silver Share - EPO
  • Select by Medica Silver Standard - EPO
  • MENDING Direct Primary Care Bronze 4950 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Gold $0 Ded ($0 DPC $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Silver 2300 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Standard Bronze (No Direct Primary Care, for DPC select DPC Bronze) - HMO
  • MENDING Standard Gold (No Direct Primary Care, for DPC select DPC Gold) - HMO
  • MENDING Standard Silver (No Direct Primary Care, for DPC select DPC Silver) - HMO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • Moda Select Alaska Bronze 6500 - PPO
  • Moda Select Alaska Bronze HDHP 5500 - PPO
  • Moda Select Alaska Gold 1500 - PPO
  • Moda Select Alaska Silver 4500 - PPO
  • Moda Select Alaska Standard Bronze - PPO
  • Moda Select Alaska Standard Gold - PPO
  • Moda Select Alaska Standard Silver - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JACEY COLE

Authorized Official Title
OWNER
Authorized Official Phone
(918) 336-2140

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
100232160AMEDICAID (05)OK 
3703801OTHER (01)NCPDP PROVIDER IDENTIFICATION NUMBER

Reviews for BOULEVARD PHARMACY

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Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Pharmacist
1117 SE FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74003
Pharmacist
1117 SE FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74003
Pharmacist
1117 SE FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74003
Pharmacist
1117 SE FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74003
Pharmacist
1117 SE FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74003
Durable Medical Equipment & Medical Supplies
1117 SE FRANK PHILLIPS BLVD
BARTLESVILLE, OK 74003

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477638567, enumerated as an "organization" on October 26, 2006.

The provider is located at 1117 SE FRANK PHILLIPS BLVD BARTLESVILLE, OK 74003 and the phone number is (918) 336-2140.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Medica, Mending Health, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to verify.