Mandrin Shima

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

16975 Issued in OK

Practice address

4900 S Sooner Rd
Oklahoma City, OK 73135-5428

Phone

(405) 458-6260

NPI assigned

Nov 9, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Oklahoma City, OK
  • NPI 1649678566
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1356943070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S SOONER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731355428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 S SOONER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731355428",
            "telephone_number": "405-458-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMA",
        "first_name": "MANDRIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "16975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena Reem Shibib, D.O.
• Carenza Angeline Shields, PTA
• George S Shields, OD
• Jordan Aerial Shields
• Mary Shilling, RD
• Chelsey Alexandra Shimanek, M.A. CCC-SLP
• Sarah D Shinault-Williams, CM
• Shine Bright Family Services
• Shawna Shine
• Shining Steps ABA of Oklahoma LLC

• Community/Retail Pharmacy in Oklahoma City, OK
• Providers in Oklahoma City, 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 Nov 9, 2020; 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.