OrganizationActive
Matt'S Country Boy Pharmacy LLC
NPI 1164774709 · Pharmacy · Choctaw, OK
Matt'S Country Boy Pharmacy LLC is a Pharmacy organization in Choctaw, OK (NPI 1164774709).
Provider details
- NPI number
- 1164774709
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Matt Evans, Pharmacist/Owner(405) 390-3205
Specialties & taxonomies
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
14890 Se 29th St Ste 108
Choctaw, OK 73020-3516
Phone: (405) 390-3205
Fax: (405) 390-2516
Street-level locationGet directions
Mailing address
14890 Se 29th St Ste 108
Choctaw, OK 73020-3516
Other names (DBA / former)
- Doing business as
- Country Boy Pharmacy
Registry dates
- Enumerated
- 2012-10-05
- Last updated
- 2016-08-25
Frequently asked questions
- What is Matt'S Country Boy Pharmacy LLC's NPI number?
- Matt'S Country Boy Pharmacy LLC's National Provider Identifier (NPI) is 1164774709, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Matt'S Country Boy Pharmacy LLC?
- Matt'S Country Boy Pharmacy LLC is classified in the NPPES registry as Pharmacy (Suppliers).
- Where is Matt'S Country Boy Pharmacy LLC located?
- Matt'S Country Boy Pharmacy LLC's practice location on file with NPPES is 14890 Se 29th St Ste 108, Choctaw, OK 73020-3516.
- What is Matt'S Country Boy Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Matt'S Country Boy Pharmacy LLC is (405) 390-3205.
- Who is the authorized official for Matt'S Country Boy Pharmacy LLC?
- The authorized official listed on Matt'S Country Boy Pharmacy LLC's NPPES record is Matt Evans, Pharmacist/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Matt'S Country Boy Pharmacy LLC's NPI active?
- Yes — Matt'S Country Boy Pharmacy LLC's NPI (1164774709) is active in the NPPES registry as of the last update on 2016-08-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.