Sooner Pharmacy of Davis Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

55-4238 Issued in OK

Legal business name

SOONER PHARMACY OF DAVIS INC

Practice address

705 E Main St
Davis, OK 73030-1913

Phone

(580) 369-3776

Fax

(580) 369-2115

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Michael Lee, RPHNPI 1851433734

Title

President

Phone

(580) 369-3776

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• SOONER PHARMACY OF DAVIS Doing business as

Locations

Practitioners 1

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

• Michael Eugene Lee, D.PH.

  • Pharmacist
  • Davis, OK
  • NPI 1851433734
  NPD (past) Authorized official

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1083625628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E MAIN ST",
            "city": "DAVIS",
            "state": "OK",
            "postal_code": "730301913",
            "telephone_number": "580-369-3776",
            "fax_number": "580-369-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E MAIN ST",
            "city": "DAVIS",
            "state": "OK",
            "postal_code": "730301913",
            "telephone_number": "580-369-3776",
            "fax_number": "580-369-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOONER PHARMACY OF DAVIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-369-3776",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "55-4238",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100238120A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2073930",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOONER PHARMACY OF DAVIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Davis, OK
• Providers in Davis, 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 Jul 2, 2014; 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.