Provider Demographics
NPI:1780303222
Name:CAIN, STEVEN B (PHARM D)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:CAIN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 PINON PL
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5600
Mailing Address - Country:US
Mailing Address - Phone:405-615-7840
Mailing Address - Fax:
Practice Address - Street 1:410 W EDMOND RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5602
Practice Address - Country:US
Practice Address - Phone:405-341-1504
Practice Address - Fax:405-341-1506
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA