NPIMap

Organization Active NPI

Beaver County Memorial Hospital

Doing business as Community Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Beaver, OK
National Provider Identifier
1013195684
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
693029 Issued in OK
Legal business name
BEAVER COUNTY MEMORIAL HOSPITAL
Doing business as
Community Pharmacy
Practice address
212 East 8TH Street
Beaver, OK 73932
Phone
(580) 625-3646
Fax
(580) 625-3844
NPI assigned
Feb 6, 2008
Last updated
Feb 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Authorized official

Name
Alissa Schlessman
Title
Administrator
Phone
(580) 625-4551

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 693029 OK Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 693029 OK
Oxygen Equipment & Supplies (DME) 332BX2000X 693029 OK
Community/Retail Pharmacy 3336C0003X 693029 OK
Institutional Pharmacy 3336I0012X 693029 OK
Long Term Care Pharmacy 3336L0003X 693029 OK
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

212 East 8TH Street
Beaver, OK 73932

Mailing address

PO Box 640
Beaver, OK 73932-0640
Phone (580) 625-3646

Other names 1

  • Community Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060815000248 OK Part B Supplier - Mass Immunization (Roster Biller Only) 9335134246 1 other NPI on this enrollment
Practice locations: Beaver, OK
O20100930007152 OK DME Supplier - Pharmacy 9335134246 Practice locations: Beaver, OK

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Beaver Cnty Memorial Hosp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beaver County Memorial HospitalBeaver, OK, CCN 37Z322 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1966
Jan 1, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1013195684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "BEAVER",
            "state": "OK",
            "postal_code": "739320640",
            "telephone_number": "580-625-3646",
            "fax_number": "580-625-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 EAST 8TH STREET",
            "city": "BEAVER",
            "state": "OK",
            "postal_code": "73932",
            "telephone_number": "580-625-3646",
            "fax_number": "580-625-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "SCHLESSMAN",
        "authorized_official_first_name": "ALISSA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-625-4551"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "693029",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "OK",
            "license": "693029",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "OK",
            "license": "693029",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "693029",
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "OK",
            "license": "693029",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OK",
            "license": "693029",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaver, OK

Sources for this page

Verify at the official NPI Registry.