Broderick Enterprises, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

23-8228 Issued in OK

Legal business name

BRODERICK ENTERPRISES, LLC

Doing business as

McCortney's Family Pharmacy & Compounding Center
Vintage Drug Company

Practice address

711 E 9TH St
Ada, OK 74820-3807

Phone

(580) 332-3344

Fax

(580) 332-3616

NPI assigned

Aug 1, 2018

Last updated

Oct 3, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Zack Broderick, PHARMDNPI 1992275465

Title

Pharmacist/Ower

Phone

(580) 332-3344

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• McCortney's Family Pharmacy & Compounding Center Doing business as
• Vintage Drug Company Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

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.

• Zack Langdon Broderick, PHARMD

  • Pharmacist
  • Ada, OK
  • NPI 1992275465
  NPD Authorized official

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759449600000",
    "number": "1073091070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E 9TH ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203807",
            "telephone_number": "580-332-3344",
            "fax_number": "580-332-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E 9TH ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203807",
            "telephone_number": "580-332-3344",
            "fax_number": "580-332-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRODERICK ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A",
        "authorized_official_last_name": "BRODERICK",
        "authorized_official_first_name": "ZACK",
        "authorized_official_title_or_position": "PHARMACIST/OWER",
        "authorized_official_telephone_number": "580-332-3344",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "23-8228",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200803550A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCortney's Family Pharmacy & Compounding Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vintage Drug Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dani Bough-David Brecheen, CM II
• Susan Dorothy Brecheen, RN
• Laura Eve Brewer-James, APRN
• Brian D. Coerver, DDS
• Stacie Brockhoff, B.H.R.S.
• Zack Langdon Broderick, PHARMD
• Christina A Brogdon
• Tangra Lea Broge, MD
• Marla Bronson, LPC
• Britney Brooks-Teel

• Community/Retail Pharmacy in Ada, OK
• Providers in Ada, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.