Harrison Discount Pharmacy PLLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

104728 Issued in OK

Legal business name

HARRISON DISCOUNT PHARMACY PLLC

Doing business as

Harrison Discount Pharmacy

Practice address

1442 N Harrison Ave
Shawnee, OK 74801-5208

Phone

(405) 273-9906

Fax

(405) 273-4329

NPI assigned

Oct 26, 2006

Last updated

Feb 17, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David NicklasNPI 1073523932

Title

Owner

Phone

(405) 273-9906

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• HARRISON DISCOUNT PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Eugene Nicklas, DPH

  • Pharmacist
  • Shawnee, OK
  • NPI 1073523932
  NPD Authorized official
• Jathan Cole Coburn, PHARM. D.

  • Pharmacist
  • Shawnee, OK
  • NPI 1932393923
  NPD (past)
• Chad Thomas

  • Pharmacist
  • Shawnee, OK
  • NPI 1003362120
  NPD (past)
• Robin Gayle Underwood

  • Pharmacy Technician
  • Shawnee, OK
  • NPI 1497765366
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1700961091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 N HARRISON AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748015208",
            "telephone_number": "405-273-9906",
            "fax_number": "405-273-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 N HARRISON AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748015208",
            "telephone_number": "405-273-9906",
            "fax_number": "405-273-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISON DISCOUNT PHARMACY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "NICKLAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-273-9906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "104728",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100239400A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074147",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HARRISON DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harmony Counseling, PLLC
• Baylee Harris
• Kelli Harris
• Shaya Leigh Harris
• Wendy Dione Harris, LMFT
• Delaina Lynn Harrison
• Kristopher K. Hart, D.O.
• Harrison Blake Hartzell
• Jordan Leigh Harvey
• Bethany Haskins

• Community/Retail Pharmacy in Shawnee, OK
• Providers in Shawnee, 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 Feb 17, 2016; 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.