Semdrug, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SEMDRUG, LLC

Doing business as

SEMINOLE DRUG
SEMINOLE DRUG INC

Practice address

1717 N Milt Phillips Ave
Seminole, OK 74868-2333

Phone

(405) 382-5420

Fax

(405) 382-6146

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kerry D Kincade, DPH

Title

Member

Phone

(405) 808-3226

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• SEMINOLE DRUG Doing business as
• SEMINOLE DRUG INC Doing business as

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1144305269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 N MILT PHILLIPS AVE",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748682333",
            "telephone_number": "405-382-5420",
            "fax_number": "405-382-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N MILT PHILLIPS AVE",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748682333",
            "telephone_number": "405-382-5420",
            "fax_number": "405-382-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMDRUG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2021-12-08",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "KINCADE",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "405-808-3226",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2073457",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100235950A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SEMINOLE DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SEMINOLE DRUG INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SEMINOLE DRUG INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Seminole, OK
• Providers in Seminole, 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 Dec 8, 2021; 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.