Eddie D Allen, DPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

8872 Issued in OK

Practice address

659 S Park Dr
Broken Bow, OK 74728-5331

Phone

(580) 584-5841

Fax

(580) 584-5845

NPI assigned

Dec 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• E D Allens Pharmacy of Broken Bow Inc

  dba Eddie Allens Pharmacy

  • Community/Retail Pharmacy
  • Broken Bow, OK
  • NPI 1609938349
  Authorized official Same address or phone

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073675732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 S PARK DR",
            "address_2": "PO BOX 997",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285331",
            "telephone_number": "580-584-5841",
            "fax_number": "580-584-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 S PARK DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285331",
            "telephone_number": "580-584-5841",
            "fax_number": "580-584-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "EDDIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "8872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Broken Bow, OK
• Providers in Broken Bow, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.