Ralls Enterprises Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25-4396 Issued in OK

Legal business name

RALLS ENTERPRISES INC

Doing business as

Palace Drug

Practice address

1200 SE Lincoln Rd
Idabel, OK 74745-7358

Phone

(580) 286-2190

Fax

(580) 286-5260

NPI assigned

Aug 21, 2006

Last updated

Jul 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

W a Ralls

Title

Owner

Phone

(580) 286-2190

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PALACE DRUG Doing business as

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1588779136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SE LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457358",
            "telephone_number": "580-286-2190",
            "fax_number": "580-286-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SE LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457358",
            "telephone_number": "580-286-2190",
            "fax_number": "580-286-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALLS ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "RALLS",
        "authorized_official_first_name": "W A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-286-2190"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "25-4396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2072937",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100241680A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALACE DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PALACE DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Idabel, OK
• Providers in Idabel, 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 Jul 20, 2021; 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.