Organization Active NPI

Bestyet Pharmacy LLC

  • Community/Retail Pharmacy
  • Harrah, OK
National Provider Identifier
1093716342
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1-7754 Issued in OK
Legal business name
BESTYET PHARMACY LLC
Practice address
19671 NE 23Rd St
Harrah, OK 73045-9305
Phone
(405) 454-6261
Fax
(405) 454-6262
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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

Authorized official

Name
Justin Blake Wilson, PHARMD
Title
Owner
Phone
(405) 741-1200

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1-7754 OK Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

19671 NE 23Rd St
Harrah, OK 73045-9305

Mailing address

PO Box 98
Harrah, OK 73045-0098
Phone (405) 454-6261

Other identifiers 3

IdentifierTypeStateIssuer
100239820BMedicaidOK
100239820AMedicaidOK
2074157OtherPK

Other names 1

  • BESTYET HEALTHMART PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060919000019 OK Part B Supplier - Mass Immunization (Roster Biller Only) 8628073046 Practice locations: Harrah, OK

National Provider Directory

National Provider Directory

Locations

19671 NE 23rd St
Harrah, OK 73045
Phone (405) 454-6261

19655 NE 23rd St
Harrah, OK 73045
Phone (405) 454-6261

Practitioners & affiliated clinicians

Practitioners 3

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": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636156800000",
    "number": "1093716342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730450098",
            "telephone_number": "405-454-6261",
            "fax_number": "405-454-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19671 NE 23RD ST",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730459305",
            "telephone_number": "405-454-6261",
            "fax_number": "405-454-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESTYET PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-741-1200",
        "authorized_official_credential": "PHARMD"
    },
    "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": "1-7754",
            "primary": true
        },
        {
            "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": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100239820B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100239820A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074157",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BESTYET HEALTHMART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BESTYET HEALTHMART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2021; 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.