PRUETT FOODS PHARMACY – Community/Retail Pharmacy, NPI 1689673832
Community/Retail Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for PRUETT FOODS PHARMACY
201, South Park Drive, Broken Bow, McCurtain County, Oklahoma, 74728, United States
BROKEN BOW, OK 747284737
Phone: (580) 584-6085
Fax: (580) 584-6088
Type: Mailing
210 MAIN STREET
BROKEN BOW, OK 747284737
Phone: (580) 584-6056
Fax: (580) 584-6088
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-09-21
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 88 | 88 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 83 | 83 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 30 | 30 | $0 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 30 | 30 | $0 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 11 | 11 | $0 |
Insurance plans in this area (ZIP 74728)
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