NPIMap

Organization Active NPI

Oklahoma State University

Doing business as OSU University Health Services Pharmacy

  • Student Health Clinic/Center
  • Stillwater, OK
National Provider Identifier
1598827776
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
8-3015 Issued in OK
Legal business name
OKLAHOMA STATE UNIVERSITY
Doing business as
OSU University Health Services Pharmacy
Practice address
1202 W Farm Rd
Stillwater, OK 74078-2036
Phone
(405) 744-7665
Fax
(405) 744-2136
NPI assigned
Dec 14, 2006
Last updated
Jan 25, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OSU UNVIVERSITY HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Mr. Jack Henneha
Title
Associate Director
Phone
(405) 744-7665

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X 8-3015 OK Primary
Pharmacy 333600000X

Addresses

Primary practice location

1202 W Farm Rd
Stillwater, OK 74078-2036

Mailing address

1202 W Farm Rd
Stillwater, OK 74078-2036
Phone (405) 744-7025

Other identifiers 2

IdentifierTypeStateIssuer
736017987OtherOKFEDERAL TAX ID
100757330FMedicaidOK

Other names 1

  • OSU University Health Services Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma Forensic Center140 organizations share this tax ID, including this one
Part of
Oklahoma State University

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1598827776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W FARM RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740782036",
            "telephone_number": "405-744-7025",
            "fax_number": "405-744-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W FARM RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740782036",
            "telephone_number": "405-744-7665",
            "fax_number": "405-744-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSU UNVIVERSITY HEALTH SERVICES",
        "enumeration_date": "2006-12-14",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "HENNEHA",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "405-744-7665",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "OK",
            "license": "8-3015",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "736017987",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100757330F",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU University Health Services Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.