NPIMap

Organization Active NPI

Fikes Boomtown Drug, Inc.

Doing business as Boomtown Drug

  • Durable Medical Equipment & Medical Supplies
  • Burkburnett, TX
National Provider Identifier
1548460801
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
25627 Issued in TX
Legal business name
FIKES BOOMTOWN DRUG, INC.
Doing business as
Boomtown Drug
Practice address
514 S. Oklahoma Cutoff
Burkburnett, TX 76354
Phone
(940) 569-5600
Fax
(940) 569-5608
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Authorized official

Name
Cory Fikes, D.PH.
Title
President/Owner
Phone
(940) 569-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 25627 TX Primary

Addresses

Primary practice location

514 S. Oklahoma Cutoff
Burkburnett, TX 76354

Mailing address

PO Box 805
Burkburnett, TX 76354-0805
Phone (940) 569-5600

Other identifiers 1

IdentifierTypeStateIssuer
4545351OtherTXNCPDP

Other names 1

  • Boomtown Drug Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Boomtown Drug2 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.

Practitioners & affiliated clinicians

Practitioners 3

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": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1548460801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 805",
            "city": "BURKBURNETT",
            "state": "TX",
            "postal_code": "763540805",
            "telephone_number": "940-569-5600",
            "fax_number": "940-569-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S. OKLAHOMA CUTOFF",
            "city": "BURKBURNETT",
            "state": "TX",
            "postal_code": "76354",
            "telephone_number": "940-569-5600",
            "fax_number": "940-569-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIKES BOOMTOWN DRUG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "FIKES",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "940-569-5600",
        "authorized_official_credential": "D.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "25627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4545351",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boomtown Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burkburnett, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.