Matt's Country Boy Pharmacy Llc
Pharmacy
14890 Se 29th St Ste 108, Choctaw
Oklahoma, 73020-3516
405-390-3205 405-390-2516
Matt's Country Boy Pharmacy Llc is a Pharmacy in Choctaw, Oklahoma. It is located at 14890 Se 29th St Ste 108, Choctaw and it's customer support contact number is 405-390-3205. The authorized person of Matt's Country Boy Pharmacy Llc is Matt Evans who is Pharmacist/owner of the pharmacy and his contact number is 405-390-3205. Active license number of Matt's Country Boy Pharmacy Llc is 1-6052 for Pharmacy in Oklahoma.
Matt's Country Boy Pharmacy Llc is 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.
Pharmacy Details:
Matt's Country Boy Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Matt's Country Boy Pharmacy Llc |
| Type: | Pharmacy |
| Location: | 14890 Se 29th St Ste 108, Choctaw,
Oklahoma, 73020-3516 |
| Phone: | 405-390-3205 |
| Fax: | 405-390-2516 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Matt Evans |
| Position: | Pharmacist/owner |
| Contact Number: | 405-390-3205 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1164774709 |
| NPI Enumeration Date: | 05 Oct, 2012 |
| NPI Last Update On: | 25 Aug, 2016 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Matt's Country Boy Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pharmacy | 1-6052 | Oklahoma | Primary | |
| Community/Retail Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2137264 | Other | | Pk |
| 200464490A | Medicaid | Oklahoma | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 14890 Se 29th St Ste 108,
Choctaw, Oklahoma |
| Zip: | 73020-3516 |
| Phone Number: | 405-390-3205 |
| Fax Number: | 405-390-2516 |
Patients can reach Matt's Country Boy Pharmacy Llc at
14890 Se 29th St Ste 108, Choctaw, Oklahoma or can
call on customer care at 405-390-3205.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.