Pharm Vinita Acquisition LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

37-5146 Issued in OK

Legal business name

PHARM VINITA ACQUISITION LLC

Practice address

201 N Scraper St
Vinita, OK 74301-3209

Phone

(918) 256-2541

Fax

(918) 256-5295

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Matthew Finn

Title

Officer

Phone

(918) 256-2541

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• V & V Drug Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Tax ID family

Pharm Vinita Acquisition LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pharm Vinita Acquisition LLC

  • Long Term Care Pharmacy
  • Vinita, OK
  • NPI 1093491433
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pharm Vinita Acquisition LLC

  • Long Term Care Pharmacy
  • Vinita, OK
  • NPI 1093491433
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronnie Logan Davis, D.PH.

  • Pharmacist
  • Vinita, OK
  • NPI 1649341710
  NPD (past)
• Amelia Morgan, PHARM.D.

  • Pharmacist
  • Vinita, OK
  • NPI 1740883438
  NPD (past)
• Ronald Cary White, PHARMACIST

  • Pharmacist
  • Vinita, OK
  • NPI 1144043324
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1407938202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N SCRAPER ST",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743013209",
            "telephone_number": "918-256-2541",
            "fax_number": "918-256-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N SCRAPER ST",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743013209",
            "telephone_number": "918-256-2541",
            "fax_number": "918-256-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARM VINITA ACQUISITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "FINN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "918-256-2541"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "37-5146",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100234200A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081542",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "V & V Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Devon Pedersen-Davis
• Reginald A Perry
• Shelby Dell Perry
• Carol Lynn Peters, COTA/L
• Pharm Vinita Acquisition LLC
• Denise Lynn Phelps
• Curtis Alan Phillips, D.O.
• Melanie K Phillips
• Lyndsay Lanee Piguet, RN
• Amanda Kay Pipins, LPC

• Community/Retail Pharmacy in Vinita, OK
• Providers in Vinita, 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 Apr 1, 2022; 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.