Individual provider Active NPI

Bibeth Banares Vasquez, RPH

  • Pharmacist
  • Broken Arrow, OK
National Provider Identifier
1619572070
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13555 Issued in OK
Practice address
2351 N 9TH St
Broken Arrow, OK 74012-2850
Phone
(918) 355-1293
NPI assigned
Dec 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13555 OK Primary

Addresses

Primary practice location

2351 N 9TH St
Broken Arrow, OK 74012-2850

Mailing address

2351 N 9TH St
Broken Arrow, OK 74012-2850
Phone (918) 355-1293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13555OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma CVS Pharmacy LLC PastSince Dec 6, 2020 Accepting new patients
Oklahoma CVS Pharmacy LLC PastSince Dec 6, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1619572070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 N 9TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122850",
            "telephone_number": "918-355-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 N 9TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122850",
            "telephone_number": "918-355-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "BIBETH",
        "middle_name": "BANARES",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "13555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.