Diana Sue Bagent, DPH
Individual provider Active NPI Pharmacist · Salina, OK
NPI 1609076264 · NPPES record last updated Jul 23, 2007
Key facts
- NPI
- 1609076264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11077 (OK)
- Practice address
- 900 N Owen Walters Blvd
Salina, OK 74365-5003 - Phone
- (918) 434-8507
- Fax
- (918) 434-8597
- NPI assigned
- Jul 23, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11077 | OK | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11077 | OK | Yes |
Addresses
Primary practice location
900 N Owen Walters Blvd
Salina, OK 74365-5003
Mailing address
900 N Owen Walters Blvd
Salina, OK 74365-5003
Phone (918) 434-8507
Other providers in Salina, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2007. 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.