Tecumseh Medical Clinic Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10-5267 Issued in OK

Legal business name

TECUMSEH MEDICAL CLINIC PHARMACY LLC

Practice address

418 E Walnut St
Suite 100
Tecumseh, OK 74873-2200

Phone

(405) 598-6597

Fax

(405) 598-6103

NPI assigned

Aug 19, 2006

Last updated

Oct 16, 2017By 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

Richard Fisher

Title

Owner

Phone

(405) 598-6597

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1417061953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 E WALNUT ST",
            "address_2": "SUITE 100",
            "city": "TECUMSEH",
            "state": "OK",
            "postal_code": "748732200",
            "telephone_number": "405-598-6597",
            "fax_number": "405-598-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 E WALNUT ST",
            "address_2": "SUITE 100",
            "city": "TECUMSEH",
            "state": "OK",
            "postal_code": "748732200",
            "telephone_number": "405-598-6597",
            "fax_number": "405-598-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECUMSEH MEDICAL CLINIC PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-598-6597"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "10-5267",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074942",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100244260A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tecumseh Dental Clinic
• Tecumseh Eye Associates PLLC
• Tecumseh Eye Clinic PLLC (Harrah Eye Clinic)
• Tecumseh Family Dentistry PLLC
• Tecumseh Medical Clinic PC
• Tecumseh Operations. LLC (Sunset Estates)
• Tecumseh Public Schools
• Thushara Thomas
• Stephanie Ray Tison
• Julie Anna Tobin-Branham, M.A.

• Community/Retail Pharmacy in Tecumseh, OK
• Providers in Tecumseh, 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 Oct 16, 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.