GLN of Checotah Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

483935 Issued in OK

Legal business name

GLN OF CHECOTAH INC

Practice address

207 N Broadway St
Checotah, OK 74426-2431

Phone

(918) 473-2304

Fax

(918) 473-6133

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Amy L. Garrett, PHARM.D.

Title

Pharmacy Manager

Phone

(918) 473-2304

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• NICHOLS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1154416162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROADWAY ST",
            "city": "CHECOTAH",
            "state": "OK",
            "postal_code": "744262431",
            "telephone_number": "918-473-2304",
            "fax_number": "918-473-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N BROADWAY ST",
            "city": "CHECOTAH",
            "state": "OK",
            "postal_code": "744262431",
            "telephone_number": "918-473-2304",
            "fax_number": "918-473-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLN OF CHECOTAH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "918-473-2304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "483935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100243600A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NICHOLS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda A Elfezzazi, APRN-CNP, AGPCNP
• Laura Gayle Fairchild
• Sherrie Francisco
• Joycelyn J Garcia
• Jesse Jolee Gatewood, PHARM D
• Green Country Chiropractic, Inc.
• Shannon Diane Griggs, RPH
• Joyce Grisham
• Carol Grover
• Misty J Haraway, PA

• Community/Retail Pharmacy in Checotah, OK
• Providers in Checotah, 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 Mar 15, 2011; 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.