Active NPI
Dedmon Pharmacy Inc
- Long Term Care Pharmacy
- Spiro, OK
National Provider Identifier
1326508706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- DEDMON PHARMACY INC
- Practice address
- 213 W Broadway St
Spiro, OK 74959-2419 - Phone
- (918) 962-2131
- Fax
- (918) 962-5750
- NPI assigned
- Mar 22, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bradley Wayne Dedmon, PHARM D
- Title
- President
- Phone
- (918) 962-2131
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
213 W Broadway St
Spiro, OK 74959-2419
Mailing address
PO Box 220
Spiro, OK 74959-0220
Phone (918) 962-2131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100246960B | Medicaid | OK |
National Provider Directory
National Provider Directory- Tax ID family
- Dedmon Pharmacy Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Spiro, OK
- NPI 1821181264
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Spiro, OK
- NPI 1497881098
-
- Pharmacist
- Spiro, OK
- NPI 1679493779
-
- Pharmacist
- Fort Smith, AR
- NPI 1922147834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1553212800000",
"number": "1326508706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 220",
"city": "SPIRO",
"state": "OK",
"postal_code": "749590220",
"telephone_number": "918-962-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 W BROADWAY ST",
"city": "SPIRO",
"state": "OK",
"postal_code": "749592419",
"telephone_number": "918-962-2131",
"fax_number": "918-962-5750"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DEDMON PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-22",
"last_updated": "2019-03-22",
"status": "A",
"authorized_official_last_name": "DEDMON",
"authorized_official_first_name": "BRADLEY",
"authorized_official_middle_name": "WAYNE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "918-962-2131",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARM D"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100246960B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spiro, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.