GLN of Holdenville, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

40-4623 Issued in OK

Legal business name

GLN OF HOLDENVILLE, INC

Doing business as

Nichols Pharmacy

Practice address

203 E Highway St
Holdenville, OK 74848-4011

Phone

(405) 379-3381

Fax

(405) 379-3962

NPI assigned

Dec 28, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Stephen L Summers, DPH

Title

Pharmacist in Charge

Phone

(405) 379-3381

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• NICHOLS PHARMACY Doing business as

Locations

Practitioners 1

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

• Gina Danielle Garrett, DPH

  • Pharmacist
  • Ada, OK
  • NPI 1689261315
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295827200000",
    "number": "1275510471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E HIGHWAY ST",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748484011",
            "telephone_number": "405-379-3381",
            "fax_number": "405-379-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E HIGHWAY ST",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748484011",
            "telephone_number": "405-379-3381",
            "fax_number": "405-379-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLN OF HOLDENVILLE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2011-01-24",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "405-379-3381",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OK",
            "license": "40-4623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200002680A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3713650",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NICHOLS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenya Fields
• Terri L Ford
• Willard Bill Freeman, D.C.
• Jennifer Michele Gaines
• Michael J Gibson, P.A.-C.
• Helen Celeste Gordon, R.N.
• Alicia Rose Gosey, APRN-CNP
• Itha Joyce Gray, ICADC
• Katherine Denise Lynn Green, APRN
• Groundwork Counseling & Consulting PLLC

• Pharmacy in Holdenville, OK
• Providers in Holdenville, OK by specialty
• Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.