Larry David Brim

Primary specialty

PharmacistTaxonomy code 183500000X

License

11352 Issued in OK

Practice address

1151 N Lynn Riggs Blvd
Claremore, OK 74017-3068

Phone

(918) 283-3784

NPI assigned

Mar 15, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Claremore Compounding Center, Inc

  • Pharmacy
  • Claremore, OK
  • NPI 1609939529
  NPD (past)

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1003564303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N LYNN RIGGS BLVD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173068",
            "telephone_number": "918-283-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N LYNN RIGGS BLVD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173068",
            "telephone_number": "918-283-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIM",
        "first_name": "LARRY",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "11352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100245990A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "claremorecompoundingcenter.us",
            "affiliation": "N",
            "endpointDescription": "desktop",
            "address_1": "1151 N Lynn Riggs Blvd",
            "city": "Claremore",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740173068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sidney Cheyenne Brassfield
• Darcy Zola Brewer
• Regan Brewer
• Ashley Marie Bridges
• Sarah Briley
• Ashley Bristol, PTA
• Brite & Shiny Counseling, LLC
• Nakita Brite, R.D.
• Alesha Dione Britten
• Jennifer Brodie

• Pharmacist in Claremore, OK
• Providers in Claremore, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.