NPIMap

Organization Active NPI

Physician Direct Retail Pharmacy, LLC

  • Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1386154227
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PHYSICIAN DIRECT RETAIL PHARMACY, LLC
Practice address
7725 W Reno Ave
Oklahoma City, OK 73127-9711
Phone
(405) 206-1313
Fax
(405) 376-6117
NPI assigned
Oct 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Authorized official

Name
Kenneth Orton
Title
Managing Member
Phone
(405) 206-1313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

7725 W Reno Ave
Oklahoma City, OK 73127-9711

Mailing address

7725 W Reno Ave
Oklahoma City, OK 73127-9711
Phone (405) 206-1313

Other names 1

  • pdr Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507161600000",
    "number": "1386154227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731279711",
            "telephone_number": "405-206-1313",
            "fax_number": "405-376-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731279711",
            "telephone_number": "405-206-1313",
            "fax_number": "405-376-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN DIRECT RETAIL PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2017-10-05",
        "status": "A",
        "authorized_official_last_name": "ORTON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "405-206-1313"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pdr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.