Jaymarc Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

24-5489 Issued in OK

Legal business name

JAYMARC INC

Practice address

309 S Wewoka Ave
Wewoka, OK 74884-2641

Phone

(405) 257-3388

Fax

(405) 257-6508

NPI assigned

Apr 12, 2010

Organization subpart

No

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

Authorized official

Name

Mark Holley

Title

Owner

Phone

(405) 257-3388

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Roberts Drug Store Doing business as

Locations

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1275859571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "WEWOKA",
            "state": "OK",
            "postal_code": "748840728",
            "telephone_number": "405-257-3388",
            "fax_number": "405-257-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S WEWOKA AVE",
            "city": "WEWOKA",
            "state": "OK",
            "postal_code": "748842641",
            "telephone_number": "405-257-3388",
            "fax_number": "405-257-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYMARC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-257-3388"
    },
    "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": "24-5489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124569",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200296660A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roberts Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Harjo, LPC
• Karen Hearod
• Breanna Hill
• Holdenville Hospital Authority
• Indian Health Service-Wewoka
• Aaron Jahmal Johnson, PHARM D.
• Nicholas Wiley Jones
• Domika Kinman, CDA, RDH
• Lynnette Erin Lena
• Amanda Lenora

• Community/Retail Pharmacy in Wewoka, OK
• Providers in Wewoka, 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 Jan 11, 2016; 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.