Organization Active NPI

Edrei, LLC.

Doing business as Alans Pharmacy

  • Community/Retail Pharmacy
  • Stillwater, OK
National Provider Identifier
1053418996
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
83581 Issued in OK
Legal business name
EDREI, LLC.
Doing business as
Alans Pharmacy
Practice address
1721 W 6TH Ave
Stillwater, OK 74074-4200
Phone
(405) 372-3331
Fax
(405) 372-3547
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Authorized official

Name
Lisa Hladik
Title
Member/Manager
Phone
(405) 372-3331

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 83581 OK Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

1721 W 6TH Ave
Stillwater, OK 74074-4200

Mailing address

1721 W 6TH Ave
Stillwater, OK 74074-4200
Phone (405) 372-3331

Other identifiers 2

IdentifierTypeStateIssuer
2074050OtherPK
200725050AMedicaidOK

Other names 1

  • ALANS PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

1721 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-3331

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1053418996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744200",
            "telephone_number": "405-372-3331",
            "fax_number": "405-372-3547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744200",
            "telephone_number": "405-372-3331",
            "fax_number": "405-372-3547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDREI, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "HLADIK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "405-372-3331"
    },
    "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": "83581",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074050",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200725050A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALANS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ALANS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.