Okmulgee Discount Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

143741 Issued in OK

Legal business name

OKMULGEE DISCOUNT PHARMACY, LLC

Doing business as

Okmulgee Discount Pharmacy

Practice address

1160 S Belmont Ave
Okmulgee, OK 74447-6308

Phone

(918) 756-1223

Fax

(918) 756-3205

NPI assigned

Sep 30, 2006

Organization subpart

No

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

Authorized official

Name

Ryan Jay Ritter

Title

Owner

Phone

(580) 889-3353

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• OKMULGEE DISCOUNT PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

Tax ID family

Okmulgee Discount 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.

• Okmulgee Discount Pharmacy, LLC

  dba Okmulgee Discount Pharmacy

  • Long Term Care Pharmacy
  • Okmulgee, OK
  • NPI 1033801105
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Okmulgee Discount Pharmacy, LLC

  dba Okmulgee Discount Pharmacy

  • Long Term Care Pharmacy
  • Okmulgee, OK
  • NPI 1033801105
  NPPES parent name

Practitioners 1

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

• Heather Willis, PHARM D

  • Pharmacist
  • Okmulgee, OK
  • NPI 1528626934
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1518050954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S MISSISSIPPI AVE STE A",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253356",
            "telephone_number": "580-889-0230",
            "fax_number": "918-756-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 S BELMONT AVE",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476308",
            "telephone_number": "918-756-1223",
            "fax_number": "918-756-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKMULGEE DISCOUNT PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "RITTER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-889-3353"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "143741",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100242700B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074685",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100242700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OKMULGEE DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OKMULGEE DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael O'Brien, DMD
• Penny Ogbonna
• Okemah Pharmacy Management LLC (M & D Star Drug)
• Okmulgee Chiropractic Inc
• Okmulgee Discount Pharmacy, LLC (Okmulgee Discount Pharmacy)
• Okmulgee Emergency PLLC
• Okmulgee Memorial Hospital
• Okmulgee Memorial Hospital
• Okmulgee Memorial Hospital, Inc (Okmulgee Memorial Hospital)
• Okmulgee Pediatrics (Okmulgee Pediatrics & Family Care, L.L.P.)

• Community/Retail Pharmacy in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.