Hyperion LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

48-5526 Issued in OK

Legal business name

HYPERION LLC

Practice address

605 N Main St
Eufaula, OK 74432-1634

Phone

(918) 689-9940

Fax

(918) 689-7557

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Darren Tidwell

Title

Owner

Phone

(918) 689-9940

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Lakeside Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1295867612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 N MAIN ST",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744321634",
            "telephone_number": "918-689-9940",
            "fax_number": "918-689-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N MAIN ST",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744321634",
            "telephone_number": "918-689-9940",
            "fax_number": "918-689-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYPERION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-689-9940"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "48-5526",
            "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
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200287060A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125414",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Horizon Hospice Inc.
• Jessica Hope Howell, RN
• Douglas H. Huber, P.A.
• Shryl Delese Hulme
• Terri Hunter
• Hyperion, LLC
• Amanda J Iskey, APRN-CNP
• Jeay Medical Services
• Brenda Johnson, C-CHW
• Cora Johnson

• Community/Retail Pharmacy in Eufaula, OK
• Providers in Eufaula, 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 May 27, 2015; 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.