Organization Active NPI

Roys Discount Pharmacy LLC

  • Community/Retail Pharmacy
  • Wilburton, OK
National Provider Identifier
1457440141
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
67-4554 Issued in OK
Legal business name
ROYS DISCOUNT PHARMACY LLC
Doing business as
Roys Discount Pharmacy LLC
Practice address
621 Highway 2 N
Wilburton, OK 74578-3620
Phone
(918) 465-0111
Fax
(918) 465-0015
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Tawnee D TaylorNPI 1578116208
Title
Owner
Phone
(918) 465-0111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 67-4554 OK Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

621 Highway 2 N
Wilburton, OK 74578-3620

Mailing address

621 Highway 2 N
Wilburton, OK 74578-3620
Phone (918) 465-0111

Other identifiers 2

IdentifierTypeStateIssuer
2074672OtherPK
100247050AMedicaidOK

Other names 1

  • ROYS DISCOUNT PHARMACY LLC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190416001230 OK Part B Supplier - Mass Immunization (Roster Biller Only) 4082955216 Practice locations: Wilburton, OK
O20200512002905 OK Part B Supplier - Independent Clinical Laboratory 4082955216 Practice locations: Wilburton, OK

National Provider Directory

National Provider Directory
Tax ID family
Roys Discount Pharmacy 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.

Locations

621 Highway 2 N
Wilburton, OK 74578
Phone (918) 465-0111

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1457440141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 HIGHWAY 2 N",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745783620",
            "telephone_number": "918-465-0111",
            "fax_number": "800-901-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 HIGHWAY 2 N",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745783620",
            "telephone_number": "918-465-0111",
            "fax_number": "918-465-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYS DISCOUNT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "TAWNEE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-465-0111"
    },
    "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": "67-4554",
            "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": "2074672",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247050A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROYS DISCOUNT PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ROYS DISCOUNT PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilburton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.