Tbcpm LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1-5535 Issued in OK

Legal business name

TBCPM LLC

Practice address

1801 N Broadway Ave
Oklahoma City, OK 73103-3446

Phone

(405) 429-5138

Fax

(405) 521-8260

NPI assigned

Oct 14, 2010

Organization subpart

No

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

Authorized official

Name

Janie Shackelford

Title

Pic

Phone

(405) 429-5138

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Broadway Clinic Pharmacy Doing business as

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1639489529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N BROADWAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731033446",
            "telephone_number": "405-429-5138",
            "fax_number": "405-521-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N BROADWAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731033446",
            "telephone_number": "405-429-5138",
            "fax_number": "405-521-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TBCPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "JANIE",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "405-429-5138"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "1-5535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126994",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Broadway Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tisha Taylor, LMT
• Travis Dean Taylor, RPT
• Walter F Taylor IV
• Carole Tayo
• Aminah Tayyab
• Tbi Associates LLC
• Tbone Enterprises LLC
• TD Pharmacy Services, PLLC
• Charles Carvajal Te, MD
• Alecia Teacher

• Community/Retail Pharmacy in Oklahoma City, OK
• Providers in Oklahoma City, 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 Nov 2, 2016; 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.