Active NPI
Onesource LLC
Doing business as OneSource
- Community/Retail Pharmacy
- Caddo, OK
National Provider Identifier
1154733293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 27-6731
- Legal business name
- ONESOURCE LLC
- Doing business as
- OneSource
- Practice address
- 124 Buffalo St
Caddo, OK 74729-2606 - Phone
- (580) 279-6001
- Fax
- (580) 367-2206
- NPI assigned
- May 23, 2014
- Last updated
- Jun 16, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tony Hudgins
- Title
- President
- Phone
- (580) 279-6001
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 27-6731 | OK | Primary |
Addresses
Primary practice location
124 Buffalo St
Caddo, OK 74729-2606
Mailing address
31 Liberty St
Calera, OK 74730-5519
Phone (580) 302-2322
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2145875 | Other | PK | |
| 200447310B | Medicaid | OK |
Other names 1
- OneSource
National Provider Directory
National Provider Directory- Tax ID family
- Onesource
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Tuttle, OK
- NPI 1194241430
Locations
124 Buffalo St
Caddo, OK 74729
Phone (580) 279-6001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400803200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529107200000",
"number": "1154733293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 LIBERTY ST",
"city": "CALERA",
"state": "OK",
"postal_code": "747305519",
"telephone_number": "580-302-2322",
"fax_number": "580-434-6250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 BUFFALO ST",
"city": "CADDO",
"state": "OK",
"postal_code": "747292606",
"telephone_number": "580-279-6001",
"fax_number": "580-367-2206"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ONESOURCE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-05-23",
"last_updated": "2018-06-16",
"status": "A",
"authorized_official_last_name": "HUDGINS",
"authorized_official_first_name": "TONY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "580-279-6001"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "OK",
"license": "27-6731",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2145875",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200447310B",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "OneSource",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Caddo, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.