NPIMap

Organization Active NPI

State of Oklahoma

  • Long Term Care Pharmacy
  • Sulphur, OK
National Provider Identifier
1124286059
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
55-2200 Issued in OK
Legal business name
STATE OF OKLAHOMA
Practice address
304 Fairlane Ave
Sulphur, OK 73086-6861
Phone
(580) 622-7500
Fax
(580) 622-7500
NPI assigned
May 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Kris Veitch
Title
It Strategist
Phone
(405) 523-4091

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 55-2200 OK Primary

Addresses

Primary practice location

304 Fairlane Ave
Sulphur, OK 73086-6861

Mailing address

304 Fairlane Ave
Sulphur, OK 73086-6861
Phone (580) 622-7500

Other identifiers 1

IdentifierTypeStateIssuer
2175981OtherPK

Other names 1

  • Sulphur Veterans Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sallisaw State Veterans Home140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

304 Fairlane Ave
Sulphur, OK 73086
Phone (580) 622-2144

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1124286059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 FAIRLANE AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730866861",
            "telephone_number": "580-622-7500",
            "fax_number": "580-622-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 FAIRLANE AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730866861",
            "telephone_number": "580-622-7500",
            "fax_number": "580-622-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "VEITCH",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "IT STRATEGIST",
        "authorized_official_telephone_number": "405-523-4091"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OK",
            "license": "55-2200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175981",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sulphur Veterans Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sulphur, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.