Organization Active NPI

Hunter'S Grand Pharmacy, LLC

  • Long Term Care Pharmacy
  • Tulsa, OK
National Provider Identifier
1346017407
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
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

Updated by the provider on Dec 29, 2023

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3732321OtherNCPDP
2-9595OtherOKOK STATE BOARD OF PHARMACY LICENSE

Other names 1

  • Hunter's Grand Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.