Elgin Discount Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

35152 Issued in OK

Legal business name

ELGIN DISCOUNT PHARMACY INC

Practice address

7523 US Highway 277
Elgin, OK 73538-2161

Phone

(580) 492-5007

Fax

(580) 492-5090

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Mark Deevers

Title

Owner and President MNGR

Phone

(580) 492-5007

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ELGIN DISCOUNT PHARMACY Doing business as

Locations

Practitioners 1

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

• Brendan Jones, PHARMD

  • Pharmacist
  • Elgin, OK
  • NPI 1376930081
  NPD (past)

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1669487534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7523 US HIGHWAY 277",
            "city": "ELGIN",
            "state": "OK",
            "postal_code": "735382161",
            "telephone_number": "580-492-5007",
            "fax_number": "580-492-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7523 US HIGHWAY 277",
            "city": "ELGIN",
            "state": "OK",
            "postal_code": "735382161",
            "telephone_number": "580-492-5007",
            "fax_number": "580-492-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN DISCOUNT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "DEEVERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER AND PRESIDENT MNGR",
        "authorized_official_telephone_number": "580-492-5007"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "35152",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100237460A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2073849",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELGIN DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Anne Derrico, APRN-CNP
• Heather Leigh Dodson, COTA/L
• Stacy A Dudark, LCSW
• Duncan Regional Hospital, Inc
• Elgin Dental Care PC
• Elgin Pharmacy, LLC
• Elgin Physical Therapy, PLLC
• Elgin Public Schools
• Jacinda Caitlin Estep
• Sarah Euliano

• All providers in Elgin, OK
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.