Sallisawrx LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SALLISAWRX LLC

Practice address

1212A E Cherokee Ave
Sallisaw, OK 74955-5232

Phone

(918) 775-4451

Fax

(918) 775-5269

NPI assigned

May 17, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Dakota Russell Tanner, PHARM.D.NPI 1952933186

Title

Managing Member

Phone

(918) 775-4451

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Sallisaw Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

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

• Dakota Russell Tanner, PHARMD

  • Pharmacist
  • Sallisaw, OK
  • NPI 1952933186
  NPD Authorized official

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1326739749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212A E CHEROKEE AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749555232",
            "telephone_number": "918-775-4451",
            "fax_number": "918-775-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212A E CHEROKEE AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749555232",
            "telephone_number": "918-775-4451",
            "fax_number": "918-775-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLISAWRX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-17",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "DAKOTA",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "918-775-4451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100237570A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sallisaw Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sallisaw Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rikki Jo Sanders
• Lauren Sanford
• Darby Elizabeth Sawney
• Carol Sue Schmidt, P.A.

• All providers in Sallisaw, OK
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.