Molly Rachel Black, DPH
Individual provider Active NPI Pharmacist · Stigler, OK
NPI 1487254686 · NPPES record last updated May 29, 2024
Key facts
- NPI
- 1487254686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 12090 (OK)
- Practice address
- 1312 E Main St
Stigler, OK 74462-2830 - Phone
- (918) 967-3369
- Fax
- (918) 485-4461
- NPI assigned
- Oct 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past |
Accepting new patients | |
| Wal-Mart Stores East, LP | Past |
Accepting new patients | |
| Wal-Mart Stores East LP | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12090 | OK | Yes |
Addresses
Primary practice location
1312 E Main St
Stigler, OK 74462-2830
Mailing address
106494 S 4230 Rd
Checotah, OK 74426-5837
Phone (918) 519-8885
Other names
- Molly Rachel Black
Other providers in Stigler, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2024. 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.