NPIMap

Organization Active NPI

Elliott Plaza Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Pryor, OK
National Provider Identifier
1467585653
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
30-4970 Issued in OK
Legal business name
ELLIOTT PLAZA PHARMACY
Practice address
510 S Elliott St
Pryor, OK 74361-6411
Phone
(918) 825-2225
Fax
(918) 825-0972
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul Andrew Turner
Title
Member
Phone
(918) 543-8777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 30-4970 OK Primary

Addresses

Primary practice location

510 S Elliott St
Pryor, OK 74361-6411

Mailing address

510 S Elliott St
Pryor, OK 74361-6411
Phone (918) 825-2225

Other identifiers 1

IdentifierTypeStateIssuer
2000050100BMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Elliott Plaza Pharmacy2 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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467585653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S ELLIOTT ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743616411",
            "telephone_number": "918-825-2225",
            "fax_number": "918-825-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S ELLIOTT ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743616411",
            "telephone_number": "918-825-2225",
            "fax_number": "918-825-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOTT PLAZA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "918-543-8777"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "30-4970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000050100B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.