Rose Rock Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ROSE ROCK PHARMACY, LLC

Practice address

12100 S Yukon Ave Ste a
Glenpool, OK 74033-6621

Phone

(918) 321-4054

Fax

(918) 552-1030

NPI assigned

Jun 23, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Colby Greuel, PHARM. D.NPI 1457836728

Title

Owner/Pharmacist in Charge

Phone

(918) 321-4054

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rose Rock Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Rogers Drug Company Inc

  • Community/Retail Pharmacy
  • Wagoner, OK
  • NPI 1942382742

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Colby Greuel

  • Pharmacist
  • Glenpool, OK
  • NPI 1457836728
  NPD Authorized official

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1649901265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 S YUKON AVE STE A",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740336621",
            "telephone_number": "918-321-4054",
            "fax_number": "918-552-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 S YUKON AVE STE A",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740336621",
            "telephone_number": "918-321-4054",
            "fax_number": "918-552-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE ROCK PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "GREUEL",
        "authorized_official_first_name": "COLBY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "918-321-4054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201038760A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rose Rock Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Glenpool, OK
• Providers in Glenpool, 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 Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.