Iryna Bryukhanov
Individual provider Active NPI Pharmacist · Bethany, OK
NPI 1437744992 · NPPES record last updated Mar 6, 2021
Key facts
- NPI
- 1437744992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- I-9962 (OK)
- Practice address
- 2316 N Rockwell Ave
Bethany, OK 73008-5852 - Phone
- (405) 440-0342
- NPI assigned
- Mar 6, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-9962 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | I-9962 | OK | Yes |
Addresses
Primary practice location
2316 N Rockwell Ave
Bethany, OK 73008-5852
Mailing address
9701 SW 21St St
Oklahoma City, OK 73128-4960
Phone (970) 270-1602
Other providers in Bethany, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.