Deer Creek Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

20-5265 Issued in OK

Legal business name

DEER CREEK PHARMACY INC

Doing business as

Deer Creek Pharmacy

Practice address

510 N Arapaho Ave
Hydro, OK 73048-8702

Phone

(405) 663-4111

Fax

(405) 663-4114

NPI assigned

Oct 25, 2006

Last updated

Feb 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kent Abbott

Title

President

Phone

(405) 663-4111

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• DEER CREEK PHARMACY Doing business as

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1154405892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "730480130",
            "telephone_number": "405-663-4111",
            "fax_number": "405-663-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N ARAPAHO AVE",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "730488702",
            "telephone_number": "405-663-4111",
            "fax_number": "405-663-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER CREEK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-663-4111"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "20-5265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077111",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEER CREEK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenna Abbott, PHARMD
• Megan Erin Abeyta-Flores
• Dara Dawn Boatman, M. A. CCC-SLP
• Bailey Marie Daugherty
• Deer Creek Pharmacy Services Inc
• Angelica Maria Exinia, MSW, LCSW
• Faith Christian Fellowship (Care Case Management)
• Russell Allen Fanning, PTA
• James Gichuki, MS

• Community/Retail Pharmacy in Hydro, OK
• Providers in Hydro, 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 Feb 20, 2017; 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.