Active NPI
Hunter'S Grand Pharmacy, LLC
- Long Term Care Pharmacy
- Tulsa, OK
National Provider Identifier
1346017407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- HUNTER'S GRAND PHARMACY, LLC
- Practice address
- 6111 E Skelly Dr Ste 1100
Tulsa, OK 74135-6100 - Phone
- (918) 309-6774
- Fax
- (918) 309-6612
- NPI assigned
- Dec 8, 2023
- 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
- Hunter Joe Hogan III, DPH
- Title
- Operations Manager
- Phone
- (405) 640-7545
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | |||
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
6111 E Skelly Dr Ste 1100
Tulsa, OK 74135-6100
Mailing address
10120 Broadway Ext Ste 200
Oklahoma City, OK 73114-6300
Phone (405) 640-7545
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3732321 | Other | NCPDP | |
| 2-9595 | Other | OK | OK STATE BOARD OF PHARMACY LICENSE |
Other names 1
- Hunter's Grand Pharmacy
National Provider Directory
National Provider DirectoryLocations
10120 Broadway Ext
Ste 200
Oklahoma City, OK 73114
Phone (405) 640-7545
6111 E Skelly Dr
Ste 1100
Tulsa, OK 74135
Phone (918) 309-6774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701993600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1703808000000",
"number": "1346017407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10120 BROADWAY EXT STE 200",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731146300",
"telephone_number": "405-640-7545",
"fax_number": "405-418-2766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6111 E SKELLY DR STE 1100",
"city": "TULSA",
"state": "OK",
"postal_code": "741356100",
"telephone_number": "918-309-6774",
"fax_number": "918-309-6612"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUNTER'S GRAND PHARMACY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-12-08",
"last_updated": "2023-12-29",
"certification_date": "2023-12-29",
"status": "A",
"authorized_official_last_name": "HOGAN",
"authorized_official_first_name": "HUNTER",
"authorized_official_middle_name": "JOE",
"authorized_official_title_or_position": "OPERATIONS MANAGER",
"authorized_official_telephone_number": "405-640-7545",
"authorized_official_name_suffix": "III",
"authorized_official_credential": "DPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3732321",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OK STATE BOARD OF PHARMACY LICENSE",
"identifier": "2-9595",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hunter's Grand Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Hunter's Grand Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.