Organization Active NPI

Pharmcareok of Hydro Inc

  • Long Term Care Pharmacy
  • Hydro, OK
National Provider Identifier
1457380164
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PHARMCAREOK OF HYDRO INC
Practice address
510 Arapaho St
Hydro, OK 73048
Phone
(405) 663-4111
Fax
(405) 663-4114
NPI assigned
Jul 3, 2006
Last updated
Jan 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Authorized official

Name
Mr. Barney Kent Abbott, DPH
Title
Pres Ceo
Phone
(405) 663-4111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 204601 OK
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

510 Arapaho St
Hydro, OK 73048

Mailing address

PO Box 70
Hydro, OK 73048
Phone (405) 663-4111

Other identifiers 2

IdentifierTypeStateIssuer
100247290AMedicaidOK
3723384OtherNCPDP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090114000073 OK Part B Supplier - Mass Immunization (Roster Biller Only) 1951464197 Practice locations: Hydro, OK
O20100930055339 OK DME Supplier - Pharmacy 1951464197 Practice locations: Hydro, OK

National Provider Directory

National Provider Directory
Tax ID family
Pharmcareok of Hydro Inc2 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.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1457380164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "73048",
            "telephone_number": "405-663-4111",
            "fax_number": "405-663-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 ARAPAHO ST",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "73048",
            "telephone_number": "405-663-4111",
            "fax_number": "405-663-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMCAREOK OF HYDRO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "BARNEY",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PRES CEO",
        "authorized_official_telephone_number": "405-663-4111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OK",
            "license": "204601",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247290A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3723384",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hydro, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.