Individual provider Active NPI

Amos Malone, DPH

  • Nutrition Support Pharmacist
  • Harrah, OK
National Provider Identifier
1659485118
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Support PharmacistTaxonomy code 1835N1003X
License
3739 Issued in OK
Practice address
2060 N Church Ave
Harrah, OK 73045-0247
Phone
(405) 454-2477
Fax
(405) 454-3507
NPI assigned
Aug 19, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X OK 8116 OK
Nutrition Support Pharmacist 1835N1003X 3739 OK Primary

Addresses

Primary practice location

2060 N Church Ave
Harrah, OK 73045-0247

Mailing address

2430 Choctaw Dr
Choctaw, OK 73020-6565
Phone (405) 454-2476

Other names 1

  • Amos Malone Other name

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

State licenses

LicenseStateTypeSpecialty
3739OKMDOral and Maxillofacial Surgery (Dentist)
OK 8116OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Harrah Pharmacy Inc. Pharmacist Past Accepting new patients
Harrah Pharmacy Inc. Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1659485118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 CHOCTAW DR",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730206565",
            "telephone_number": "405-454-2476",
            "fax_number": "405-454-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 N CHURCH AVE",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730450247",
            "telephone_number": "405-454-2477",
            "fax_number": "405-454-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "AMOS",
        "credential": "DPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "OK 8116",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "OK",
            "license": "3739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMOS",
            "last_name": "MALONE",
            "credential": "CCN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.