Marietta Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

72-7286 Issued in OK

Legal business name

MARIETTA PHARMACY LLC

Doing business as

Marietta Pharmacy

Practice address

300 S Highway 77
Marietta, OK 73448-3447

Phone

(580) 276-5555

Fax

(580) 276-5355

NPI assigned

Jun 30, 2015

Last updated

Jun 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Jay RitterNPI 1740365972

Title

Owner

Phone

(580) 889-3353

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Marietta Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

Locations

Practitioners 5

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.

• Ryan Jay Ritter, D.PH. (PHARMACIST)

  • Pharmacist
  • Atoka, OK
  • NPI 1740365972
  Authorized official Same address or phone
• Jenny Hambrick, D.PH.

  • Pharmacist
  • Marietta, OK
  • NPI 1831252584
  NPD (past)
• Janet Hartsell

  • Pharmacist
  • Marietta, OK
  • NPI 1942863543
  NPD (past)
• Mariana Sanchez

  • Pharmacist
  • Marietta, OK
  • NPI 1780297168
  NPD (past)
• Charles Reid Schnorrenberg, RPH

  • Pharmacist
  • Marietta, OK
  • NPI 1114093002
  NPD (past)

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1356724157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S MISSISSIPPI AVE",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253355",
            "telephone_number": "580-276-5555",
            "fax_number": "580-276-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S HIGHWAY 77",
            "city": "MARIETTA",
            "state": "OK",
            "postal_code": "734483447",
            "telephone_number": "580-276-5555",
            "fax_number": "580-276-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIETTA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "RITTER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-889-3353"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "72-7286",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152842",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100235740B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100235740C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marietta Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marietta Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kecia L Loveday, RN
• Cynthia Lumsden, COTA
• Marietta Discount Pharmacy, Inc (Marietta Pharmacy)
• Marietta Family Dentistry
• Marietta Operating Co, LLC (Lake Country Nursing Center)
• Jessica K Marquez
• Maria Maynard, PHYSICIAN ASSISTANT
• McIver Vision Clinic
• Ann L. McIver, O.D.
• Mental Health Services of Southern Oklahoma

• Community/Retail Pharmacy in Marietta, OK
• Providers in Marietta, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.