Family Health Center of Southern Oklahoma Inc

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

61-7438 Issued in OK

Legal business name

FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA INC

Doing business as

Family Health Center of Southern Oklahoma Pharmacy

Practice address

610 E 24TH St
Tishomingo, OK 73460-3245

Phone

(580) 371-0203

Fax

(580) 371-0205

NPI assigned

Oct 14, 2015

Organization subpart

No

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

Authorized official

Name

Joe Don Burns, DPH

Title

Pharmacy Director

Phone

(580) 371-2343

Specialties & licenses 1

Addresses

Other names 1

• Family Health Center of Southern Oklahoma Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1427429687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603245",
            "telephone_number": "580-371-0203",
            "fax_number": "580-371-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603245",
            "telephone_number": "580-371-0203",
            "fax_number": "580-371-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "580-371-2343",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OK",
            "license": "61-7438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Center of Southern Oklahoma Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mojgan Ebrahimi, DDS
• Barbara Jo Eckman, LPN/BHCM
• Craig Kendall Edmondson, BS ED BHRS
• Kevin Edmondson
• Ralph Falconer, PA-C
• Family Health Center of Southern Oklahoma Inc
• Family Health Center of Southern Oklahoma Inc
• Randal Coy Flinn
• Kristi Ann Forbes, BHCM1,C-PRSS
• Dwight Forbis

• Clinic Pharmacy in Tishomingo, OK
• Providers in Tishomingo, OK by specialty
• Clinic Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.