NPIMap

Organization Active NPI

Central Drug LLC

Doing business as Cement Drug LLC

  • Community/Retail Pharmacy
  • Cement, OK
National Provider Identifier
1629377064
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
20-5654 Issued in OK
Legal business name
CENTRAL DRUG LLC
Doing business as
Cement Drug LLC
Practice address
307 N Main St
Cement, OK 73017-0300
Phone
(405) 489-3521
Fax
(405) 489-3521
NPI assigned
Mar 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Glenn Gilbreath Jr.
Title
Owner/Manager
Phone
(405) 224-2858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 20-5654 OK Primary

Addresses

Primary practice location

307 N Main St
Cement, OK 73017-0300

Mailing address

PO Box 300
Cement, OK 73017-0300
Phone (405) 489-3521

Other identifiers 1

IdentifierTypeStateIssuer
2130561OtherPK

Other names 1

  • Cement Drug LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1629377064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300",
            "city": "CEMENT",
            "state": "OK",
            "postal_code": "730170300",
            "telephone_number": "405-489-3521",
            "fax_number": "405-489-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N MAIN ST",
            "city": "CEMENT",
            "state": "OK",
            "postal_code": "730170300",
            "telephone_number": "405-489-3521",
            "fax_number": "405-489-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL DRUG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "GILBREATH JR.",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "405-224-2858"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "20-5654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130561",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cement Drug LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cement, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.