Sara Raejon Logan, PHARMACY TECHNICIAN

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

Practice address

410 S 32ND St
Muskogee, OK 74401-5007

Phone

(918) 683-0611

Fax

(918) 683-0620

NPI assigned

May 27, 2022

Sex

Female

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

Practice roles

Locations

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

• Ernie'S Pharmacy & Wellness Center, Inc.

  • Long Term Care Pharmacy
  • Muskogee, OK
  • NPI 1891551057
  NPD
• Ernies Pharmacy & Wellness Center

  • Community/Retail Pharmacy
  • Muskogee, OK
  • NPI 1093911604
  NPD (past)

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1154060267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S 32ND ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015007",
            "telephone_number": "918-683-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S 32ND ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015007",
            "telephone_number": "918-683-0611",
            "fax_number": "918-683-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "SARA",
        "middle_name": "RAEJON",
        "name_prefix": "Mrs.",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Lipscomb, A.R.N.P.
• Robert J Livingston, DDS ORAL AND MAXILLO
• LMC Medical Group LLC
• Sandy Rosina Locke, PHD
• Kathy Loepp, RN
• Thomas Richard Loken, D.D.S.
• Shannan Marie Loman
• Gentry Rebecca Longan, DMD
• Leslie Looper, DPH
• Sasha Lounmala

• Pharmacy Technician in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Pharmacy Technician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.