Healthcare Pharmacy of Oklahoma Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

22-6367 Issued in OK

Legal business name

HEALTHCARE PHARMACY OF OKLAHOMA INC

Doing business as

Reavis Specialty Pharmacy

Practice address

110 Burr Ave Ste a
Pauls Valley, OK 73075-3848

Phone

(405) 238-2755

Fax

(405) 238-7357

NPI assigned

Oct 23, 2013

Organization subpart

No

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

Authorized official

Name

Julie Justice

Title

Authorized Agent

Phone

(405) 447-3911

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Reavis Specialty Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383696000000",
    "number": "1063840437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BURR AVE STE A",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730753848",
            "telephone_number": "405-238-2755",
            "fax_number": "405-238-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BURR AVE STE A",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730753848",
            "telephone_number": "405-238-2755",
            "fax_number": "405-238-7357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE PHARMACY OF OKLAHOMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-11-06",
        "status": "A",
        "authorized_official_last_name": "JUSTICE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "405-447-3911"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OK",
            "license": "22-6367",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142503",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reavis Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Marie Hammonds, PT, DPT
• Subrina Harrell
• Angela Harrison
• Samantha Harrison
• Shelia Jo Hatton, LPTA
• Nathan Hector
• Retha Rene Henry, NONE
• Karri Lynn Hooper
• Mary T. Hope, PHD, LPC
• Zac Howe

• Long Term Care Pharmacy in Pauls Valley, OK
• Providers in Pauls Valley, OK by specialty
• Long Term Care Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.