Individual provider Active NPI

Elizabeth Myers, PHARM D

  • Pharmacist
  • Altus, OK
National Provider Identifier
1043973324
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19190 Issued in OK
Practice address
2101 N Main St
Altus, OK 73521-1605
Phone
(580) 477-0381
Fax
(580) 477-1749
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19190 OK Primary

Addresses

Primary practice location

2101 N Main St
Altus, OK 73521-1605

Mailing address

3801 N Park LN
Altus, OK 73521-1054

Other practice location 1

1200 E Pecan St
Altus, OK 73521-6192
Phone (580) 379-5700

Other identifiers 1

IdentifierTypeStateIssuer
19190OtherOKPHARMACIST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19190OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Keenum Pharmacy, LLC CurrentSince Oct 17, 2021 Accepting new patients
Jackson County Memorial Hospital Authority Current Accepting new patients
Rexco Drug of Altus Inc PastSince Oct 17, 2021 Accepting new patients

Locations

1200 E Pecan St
Altus, OK 73521
Phone (580) 379-5000

2101 N Main St
Altus, OK 73521
Phone (580) 477-0371

Interoperability endpoints

  • Direct secure messaging: pharmacy@direct.jcmh.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1043973324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N PARK LN",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735211054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N MAIN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735211605",
            "telephone_number": "580-477-0381",
            "fax_number": "580-477-1749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E Pecan St",
            "address_purpose": "LOCATION",
            "city": "Altus",
            "state": "OK",
            "postal_code": "735216192",
            "country_code": "US",
            "telephone_number": "580-379-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "ELIZABETH",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "19190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "19190",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.