NPIMap

Organization Active NPI

Central Oklahoma Family Medical Center Inc

Doing business as Central Ok Family Med Center Pharmacy

  • Community/Retail Pharmacy
  • Konawa, OK
National Provider Identifier
1003998980
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
244685 Issued in OK
Legal business name
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER INC
Doing business as
Central Ok Family Med Center Pharmacy
Practice address
527 W 3Rd St
Konawa, OK 74849-1415
Phone
(580) 925-8911
Fax
(580) 925-8920
NPI assigned
Oct 19, 2006
Last updated
Nov 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Authorized official

Name
Blake Worlund, PHARMD
Title
Pic
Phone
(580) 925-8911

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 244685 OK Primary

Addresses

Primary practice location

527 W 3Rd St
Konawa, OK 74849-1415

Mailing address

PO Box 358
Konawa, OK 74849-0358
Phone (580) 925-8911

Other identifiers 2

IdentifierTypeStateIssuer
2076461OtherPK
1007371601MedicaidOK

Other names 1

  • CENTRAL OK FAMILY MED CENTER PHARMACY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1003998980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748490358",
            "telephone_number": "580-925-8911",
            "fax_number": "580-925-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748491415",
            "telephone_number": "580-925-8911",
            "fax_number": "580-925-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OKLAHOMA FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-12",
        "status": "A",
        "authorized_official_last_name": "WORLUND",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "580-925-8911",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "244685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2076461",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007371601",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRAL OK FAMILY MED CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CENTRAL OK FAMILY MED CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Konawa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.