Active NPI
Colby Greuel
- Pharmacist
- Glenpool, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17704
- Practice address
- 12100 S Yukon Ave Ste a
Glenpool, OK 74033-6621 - Phone
- (918) 321-4054
- Fax
- (918) 552-1030
- NPI assigned
- Oct 2, 2018
- Last updated
- Jun 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17704 | OK | Primary |
Addresses
Primary practice location
12100 S Yukon Ave Ste a
Glenpool, OK 74033-6621
Mailing address
12100 S Yukon Ave Ste a
Glenpool, OK 74033-6621
Phone (918) 321-4054
Other practice location 1
326 E Cherokee St
Wagoner, OK 74467-4706
Phone (918) 485-2317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17704 | OK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genscripts Glenpool, LLC | Current | Accepting new patients | |
| Rose Rock Pharmacy, LLC | Current | Accepting new patients | |
| Rogers Drug Company Inc | Past | Accepting new patients |
Locations
12100 S Yukon Ave
Ste A
Glenpool, OK 74033
Phone (918) 321-4054
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rose Rock Pharmacy
- Community/Retail Pharmacy
- Glenpool, OK
- NPI 1649901265
-
dba Genscripts Pharmacy
- Community/Retail Pharmacy
- Glenpool, OK
- NPI 1033736657
-
dba Rogers Drug Company
- Community/Retail Pharmacy
- Wagoner, OK
- NPI 1942382742
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1457836728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12100 S YUKON AVE STE A",
"city": "GLENPOOL",
"state": "OK",
"postal_code": "740336621",
"telephone_number": "918-321-4054",
"fax_number": "918-552-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12100 S YUKON AVE STE A",
"city": "GLENPOOL",
"state": "OK",
"postal_code": "740336621",
"telephone_number": "918-321-4054",
"fax_number": "918-552-1030"
}
],
"practiceLocations": [
{
"address_1": "326 E Cherokee St",
"address_purpose": "LOCATION",
"city": "Wagoner",
"state": "OK",
"postal_code": "744674706",
"country_code": "US",
"telephone_number": "918-485-2317",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREUEL",
"first_name": "COLBY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-02",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "17704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenpool, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.