Micks Family Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

443868 Issued in OK

Legal business name

MICKS FAMILY PHARMACY INC.

Practice address

2116 Oklahoma Ave
Woodward, OK 73801-4258

Phone

(580) 254-3504

Fax

(580) 256-6359

NPI assigned

Aug 22, 2006

Organization subpart

No

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

Authorized official

Name

Karen Charmasson

Title

Owner

Phone

(580) 254-3504

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• MICKS FAMILY PHARMACY Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mickie Dean Charmasson, PHARMACIST

  • Pharmacist
  • Woodward, OK
  • NPI 1437710449
  NPD (past)
• McKayla Jo Trout, DOCTOR OF PHARMACY

  • Pharmacist
  • Woodward, OK
  • NPI 1275255663
  NPD (past)
• Greg Waggoner

  • Pharmacist
  • Woodward, OK
  • NPI 1205496957
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1235245309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 OKLAHOMA AVE",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738014258",
            "telephone_number": "580-254-3504",
            "fax_number": "580-256-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 OKLAHOMA AVE",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738014258",
            "telephone_number": "580-254-3504",
            "fax_number": "580-256-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICKS FAMILY PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "CHARMASSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-254-3504"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "443868",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100243170A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074440",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICKS FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tammy Lee Medina
• Chanel Meinders, LCSW
• Lori Mendenhall
• Lori Messenger, LPC
• Michael E. Aitson DDS Inc. PC
• Midtown Dental PLLC
• Leslie A Miller
• Macy Donelle Millikan, FNP
• Kristen Leigh Mills, APRN-CNP
• Adriana Minjares Luna

• Community/Retail Pharmacy in Woodward, OK
• Providers in Woodward, 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 Nov 22, 2021; 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.