CVS PHARMACY #08279
NPI 1679804934
Pharmacy in Broken Arrow, OK

Q: What is Oklahoma CVS Pharmacy LLC's NPI number?

The NPI number for Oklahoma CVS Pharmacy LLC is 1679804934. It was assigned to this organization in the NPPES registry on January 26, 2010. The provider is doing business as CVS Pharmacy #08279.

Q: What is Oklahoma CVS Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Active since January 26, 2010CLIA 37D2224401 · Waiver

2351 N 9TH ST, BROKEN ARROW, OK 74012(918) 355-1293(918) 355-1361 Get Directions Write a Review

NPPES record last updated: October 31, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Cvs Pharmacy #08279 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #08279 (NPI 1679804934) is a healthcare organization registered as a pharmacy in Broken Arrow, Oklahoma and active in the NPI registry since January 2010. The organization holds a CLIA Waiver certificate valid through May 12, 2027 and lists Susan F Colbert, Director, Managed Care Admin, as its authorized official.

NPPES Registry Identity

NPI1679804934

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameOKLAHOMA CVS PHARMACY LLC

Location Address2351 N 9TH STBroken Arrow, OK 74012

Mailing AddressOne Cvs Drive, Box 1075-pharmacy EnrollmentsWoonsocket, RI 02895 · (401) 765-1500 · Fax (401) 770-7108

Phone(918) 355-1293

Fax(918) 355-1361

Organization SubpartNo

Authorized OfficialSusan F ColbertDirector, Managed Care Admin · (401) 770-2751

Enumeration DateJanuary 26, 2010

Last NPPES UpdateOctober 31, 2013

✔ NPI 1679804934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

Definition

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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X

2351 N 9TH ST, Broken Arrow, OK 74012

Open in Google Maps ↗

Other Names 1

Doing Business AsCvs Pharmacy #08279

Other Identifiers 6

Medicare PINP00962199OK

Other3726051Ncpdp

Medicaid200113030KOK

Medicare NSC5887790037

Medicare PINOKB5986

Other200113030JOK · Medicaid Dme

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2224401

Cvs/Pharmacy #08279 Oklahoma CVS Pharmacy, LLC · Broken Arrow, OK

Active · expires May 12, 2027

CLIA Number37D2224401

Laboratory TypePharmacy

Certificate Effective DateMay 13, 2025

Certificate Expiration DateMay 12, 2027

Laboratory DirectorCheyenne G. Nguyen

Laboratory Phone(918) 355-1293

Laboratory LocationCvs/Pharmacy #08279 Oklahoma CVS Pharmacy, LLC2351 N 9th St, Broken Arrow, OK 74012

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

324 services322 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

252 services252 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

53 services53 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

27 services27 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

27 services27 patients

Medical Equipment Supplier Medicare DMEPOS 18

Medicare supplier enrollment and the product categories CVS Pharmacy #08279 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #08279

DMEPOS supplier · Broken Arrow, OKOperated by Oklahoma CVS Pharmacy LLC

✔

Accepts Medicare assignment

CVS Pharmacy #08279 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20308841

Medicare Participant SinceJanuary 1, 2023

Supplier Location2351 N 9th StBroken Arrow, OK 74012

Phone(918) 355-1293

Supplier Specialties

Pharmacy

Medicare Product Categories

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Commodes, Urinals, Bedpans

Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Leave this field empty

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BIBETH BANARES VASQUEZ RPH

Pharmacist

2351 N 9TH ST
BROKEN ARROW, OK 74012

Tulsa County (918) 355-1293

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Oklahoma CVS Pharmacy LLC's NPI number?

The NPI number for Oklahoma CVS Pharmacy LLC is 1679804934. It was assigned to this organization in the NPPES registry on January 26, 2010. The provider is doing business as CVS Pharmacy #08279.

Where is Oklahoma CVS Pharmacy LLC located?

Oklahoma CVS Pharmacy LLC is located at 2351 N 9th St, Broken Arrow, OK 74012. The listed phone number is (918) 355-1293.

What is Oklahoma CVS Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Oklahoma CVS Pharmacy LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #08279 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Oklahoma CVS Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2224401) is associated with this NPI, valid through May 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Oklahoma CVS Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 37 other insurers list Oklahoma CVS Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Oklahoma CVS Pharmacy LLC was last updated on October 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.