NPIMap

Organization Active NPI

Frederick Pharmacy, Inc.

Doing business as Health Express Pharmacy

  • Community/Retail Pharmacy
  • Frederick, OK
National Provider Identifier
1356456156
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FREDERICK PHARMACY, INC.
Doing business as
Health Express Pharmacy
Practice address
219 E Josephine
Frederick, OK 73542
Phone
(580) 335-7575
Fax
(580) 335-7577
NPI assigned
Aug 20, 2006
Last updated
Feb 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Authorized official

Name
Shane Kelly, DPH
Title
Owner
Phone
(580) 335-7575

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

219 E Josephine
Frederick, OK 73542

Mailing address

PO Box 981
Frederick, OK 73542-0981
Phone (580) 335-7575

Other identifiers 2

IdentifierTypeStateIssuer
2072540OtherPK
200008420AMedicaidOK

Other names 1

  • Health Express Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Frederick Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1356456156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 981",
            "city": "FREDERICK",
            "state": "OK",
            "postal_code": "735420981",
            "telephone_number": "580-335-7575",
            "fax_number": "580-335-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E JOSEPHINE",
            "city": "FREDERICK",
            "state": "OK",
            "postal_code": "73542",
            "telephone_number": "580-335-7575",
            "fax_number": "580-335-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-335-7575",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2072540",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200008420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Health Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frederick, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.