Provider Demographics
NPI:1841384252
Name:CUDD COMPANY LLC
Entity Type:Organization
Organization Name:CUDD COMPANY LLC
Other - Org Name:ASBURY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:CUDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-570-9496
Mailing Address - Street 1:3401 N MAY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6953
Mailing Address - Country:US
Mailing Address - Phone:405-843-6691
Mailing Address - Fax:405-848-3591
Practice Address - Street 1:3401 N MAY AVE STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6904
Practice Address - Country:US
Practice Address - Phone:405-843-6691
Practice Address - Fax:405-848-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WD0400X, 261QM2500X, 332B00000X, 332BP3500X, 333600000X, 3336C0004X, 3336L0003X, 3336S0011X
OK1-71683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacyGroup - Single Specialty
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100232840BMedicaid
OK100232840AMedicaid
2151527OtherPK