Active NPI
Carol Anne Gray
- Pharmacy Technician
- Durant, OK
National Provider Identifier
1407433618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 1097728
- Practice address
- 3712 W Main St
Durant, OK 74701-4529 - Phone
- (580) 924-5112
- Fax
- (580) 924-4551
- NPI assigned
- Mar 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 1097728 | OK | Primary |
Addresses
Primary practice location
3712 W Main St
Durant, OK 74701-4529
Mailing address
427 W Carter LN
Hendrix, OK 74741-2518
Phone (158) 057-9174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1097728 | OK | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Walmart Pharmacy 10-0975
- Community/Retail Pharmacy
- Durant, OK
- NPI 1417974544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616544000000",
"number": "1407433618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "427 W CARTER LN",
"city": "HENDRIX",
"state": "OK",
"postal_code": "747412518",
"telephone_number": "158-057-9174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3712 W MAIN ST",
"city": "DURANT",
"state": "OK",
"postal_code": "747014529",
"telephone_number": "580-924-5112",
"fax_number": "580-924-4551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "CAROL",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-24",
"last_updated": "2021-03-24",
"certification_date": "2021-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "OK",
"license": "1097728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.