NPIMap

Organization Active NPI

Pharmcareok of Durant Inc

  • Long Term Care Pharmacy
  • Durant, OK
National Provider Identifier
1356370076
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PHARMCAREOK OF DURANT INC
Practice address
102 Waldron Dr
Durant, OK 74701-1902
Phone
(580) 920-2211
Fax
(580) 920-2215
NPI assigned
Jul 3, 2006
Last updated
Jan 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Authorized official

Name
Mr. Barney Kent Abbott, DPH
Title
Pres Ceo
Phone
(405) 663-4111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 274720 OK
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

102 Waldron Dr
Durant, OK 74701-1902

Mailing address

PO Box 70
Hydro, OK 73048-0070
Phone (580) 920-2211

Other identifiers 2

IdentifierTypeStateIssuer
3723663OtherNCPAP
200015180AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120504000129 OK DME Supplier - Pharmacy 7517129786 Practice locations: Durant, OK
O20210108001617 OK Part B Supplier - Mass Immunization (Roster Biller Only) 7517129786 Practice locations: Durant, OK

National Provider Directory

National Provider Directory
Tax ID family
Pharmcareok of Durant Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2915 W University Blvd
Durant, OK 74701
Phone (580) 920-2211

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cimarron Nursing CenterKingfisher, OK, CCN 375102 Skilled nursing facility Adp of the SNF Oct 1, 2024
First Shamrock Care CenterKingfisher, OK, CCN 375416 Skilled nursing facility Adp of the SNF Nov 1, 2015
Choctaw Nation Nursing HomeAntlers, OK, CCN 375372 Skilled nursing facility Adp of the SNF Oct 1, 2024
Antlers ManorAntlers, OK, CCN 375313 Skilled nursing facility Adp of the SNF Jan 1, 2025
Calera ManorCalera, OK, CCN 375519 Skilled nursing facility Adp of the SNF Nov 1, 2015
Boyce Manor Nursing HomeHoldenville, OK, CCN 375557 Skilled nursing facility Adp of the SNF Nov 1, 2024

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1356370076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "730480070",
            "telephone_number": "580-920-2211",
            "fax_number": "877-505-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WALDRON DR",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747011902",
            "telephone_number": "580-920-2211",
            "fax_number": "580-920-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMCAREOK OF DURANT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "BARNEY",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PRES CEO",
        "authorized_official_telephone_number": "405-663-4111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OK",
            "license": "274720",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPAP",
            "identifier": "3723663",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.