Kendall Healthmart Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

22525 Issued in OK

Legal business name

KENDALL HEALTHMART INC.

Practice address

222 E Rogers Blvd
Skiatook, OK 74070-1250

Phone

(918) 396-2411

Fax

(918) 396-4067

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

David Kendall

Title

Pharmacist and Owner

Phone

(918) 396-2411

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• KENDALL DRUG Doing business as

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1023102431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E ROGERS BLVD",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740701250",
            "telephone_number": "918-396-2411",
            "fax_number": "918-396-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E ROGERS BLVD",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740701250",
            "telephone_number": "918-396-2411",
            "fax_number": "918-396-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALL HEALTHMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "KENDALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PHARMACIST AND OWNER",
        "authorized_official_telephone_number": "918-396-2411"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "22525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081523",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100238010A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KENDALL DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cassie Legg, MOT, OTR/L
• Marisa Nicole McNeely, PHARMD

• All providers in Skiatook, OK
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.