Organization Active NPI

Clayton Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Clayton, OK
National Provider Identifier
1164578902
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
534300 Issued in OK
Legal business name
CLAYTON PHARMACY
Practice address
102 Lawson Blvd
Clayton, OK 74536-0517
Phone
(918) 569-4884
Fax
(918) 569-4660
NPI assigned
Jan 26, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Jeffrey S Yanchick, MPH DPH
Title
Owner/Pic
Phone
(918) 569-4884

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 534300 OK Primary

Addresses

NPPES NPI Registry

Primary practice location

102 Lawson Blvd
Clayton, OK 74536-0517

Mailing address

102 Lawson Blvd
Clayton, OK 74536-0517
Phone (918) 569-4884

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
100244280BMedicaidOK

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 15, 2017.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1164578902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 LAWSON BLVD",
            "city": "CLAYTON",
            "state": "OK",
            "postal_code": "745360517",
            "telephone_number": "918-569-4884",
            "fax_number": "918-569-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 LAWSON BLVD",
            "city": "CLAYTON",
            "state": "OK",
            "postal_code": "745360517",
            "telephone_number": "918-569-4884",
            "fax_number": "918-569-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "YANCHICK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "918-569-4884",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH DPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "534300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100244280B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.