Elgin Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3-5152 Issued in OK

Legal business name

ELGIN PHARMACY, LLC

Practice address

12889 Commerce Dr
Elgin, OK 73538-3869

Phone

(580) 492-5007

Fax

(580) 492-5090

NPI assigned

Feb 14, 2018

Last updated

Dec 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brendan Matthew Jones, PHARMDNPI 1376930081

Title

Member

Phone

(580) 492-5007

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brendan Jones, PHARMD

  • Pharmacist
  • Elgin, OK
  • NPI 1376930081
  NPD Authorized official
• Dillan B Landers, PHARMD

  • Pharmacist
  • Lawton, OK
  • NPI 1467210526
  NPD

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1275033474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12889 COMMERCE DR",
            "city": "ELGIN",
            "state": "OK",
            "postal_code": "735383869",
            "telephone_number": "580-492-5007",
            "fax_number": "580-492-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12889 COMMERCE DR",
            "city": "ELGIN",
            "state": "OK",
            "postal_code": "735383869",
            "telephone_number": "580-492-5007",
            "fax_number": "580-492-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "580-492-5007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "3-5152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200757190A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Leigh Dodson, COTA/L
• Stacy A Dudark, LCSW
• Duncan Regional Hospital, Inc (Jefferson County Hospital dba Elgin Family Care)
• Elgin Dental Care PC
• Elgin Discount Pharmacy Inc (Elgin Discount Pharmacy)
• Elgin Physical Therapy, PLLC
• Elgin Public Schools
• Jacinda Caitlin Estep
• Sarah Euliano
• Vanessa Flores

• Community/Retail Pharmacy in Elgin, OK
• Providers in Elgin, 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 Dec 3, 2024; 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.