Provider Demographics
NPI:1336663699
Name:CPII, LLC
Entity Type:Organization
Organization Name:CPII, LLC
Other - Org Name:NEXTGENRX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARM.D.
Authorized Official - Prefix:
Authorized Official - First Name:DERIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-578-0031
Mailing Address - Street 1:811 W. NEW ORLEANS, STE 101
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011
Mailing Address - Country:US
Mailing Address - Phone:918-578-0031
Mailing Address - Fax:918-524-9365
Practice Address - Street 1:811 W. NEW ORLEANS, STE 101
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74011
Practice Address - Country:US
Practice Address - Phone:918-578-0031
Practice Address - Fax:918-524-9365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
OK2-74983336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2170211OtherPK