Olympia Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25302 Issued in OK

Legal business name

OLYMPIA PHARMACY LLC

Practice address

6802 S Olympia Ave
Ste 125
Tulsa, OK 74132-1823

Phone

(918) 398-6279

NPI assigned

Jun 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shawn Crismon, DPH

Title

Pharmacist

Phone

(918) 388-5713

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• OLYMPIA PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1003076738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE",
            "address_2": "STE 125",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321823",
            "telephone_number": "918-398-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE",
            "address_2": "STE 125",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321823",
            "telephone_number": "918-398-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "CRISMON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "918-388-5713",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "25302",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3725225",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLYMPIA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Ngologu Olu
• Mary Olubuogu
• Grace Oluloto
• Robert J Oly, ARNP
• Olympia Anesthesia, PLC
• Omci Operations LLC
• Omega Practice Management Inc
• Omni Medical Group Inc
• Omni Medical Solutions
• Milton Kevin Omondi, APRN

• Community/Retail Pharmacy in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.