Pharm Shawnee Acquisition LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PHARM SHAWNEE ACQUISITION LLC

Doing business as

Shawnee Drug

Practice address

1006 N Harrison Ave
Shawnee, OK 74801-6419

Phone

(405) 273-7360

Fax

(405) 273-4384

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Matthew Finn

Title

Officer

Phone

(469) 261-3048

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Shawnee Drug Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Tax ID family

Pharm Shawnee Acquisition2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pharm Shawnee Acquisition LLC

  • Long Term Care Pharmacy
  • Shawnee, OK
  • NPI 1568149938
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pharm Shawnee Acquisition LLC

  • Long Term Care Pharmacy
  • Shawnee, OK
  • NPI 1568149938
  NPPES parent name

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1164594958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 N HARRISON AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016419",
            "telephone_number": "405-273-7360",
            "fax_number": "405-273-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 N HARRISON AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016419",
            "telephone_number": "405-273-7360",
            "fax_number": "405-273-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARM SHAWNEE ACQUISITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "FINN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "469-261-3048"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "10-6649",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100239580A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145108",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawnee Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Marie Perdue, M.ED.
• Michelle K Peters
• Kaylin A Peterson, SLP
• Marianna Kay-Araceli Pettyjohn
• Dianna Lynn Pharaoh, LPC
• Pharm Shawnee Acquisition LLC
• Jackson Davis Phelps, LPN
• Lindsey C. Phelps, RN
• Kree Challa Phillip
• Karen Phillips, R. N.

• Community/Retail Pharmacy in Shawnee, OK
• Providers in Shawnee, 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 Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.