Southwestern Regional Hospital

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2-5010 Issued in OK

Legal business name

SOUTHWESTERN REGIONAL HOSPITAL

Practice address

10109 E 79TH St
Tulsa, OK 74133-4564

Phone

(918) 286-5370

Fax

(918) 286-5243

NPI assigned

Nov 1, 2006

Last updated

Jul 2, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHWESTERN REGIONAL HOSPITALAs reported in NPPES

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

Authorized official

Name

Debra Dufour

Title

Pharmacist

Phone

(918) 286-5370

Specialties & licenses 1

Addresses

Other names 1

• Attn: Pharmacy and Nutrition Shoppe Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Part of

Southwestern Regional Medical Center LLC

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1700963113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10109 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334564",
            "telephone_number": "918-286-5370",
            "fax_number": "918-286-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10109 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334564",
            "telephone_number": "918-286-5370",
            "fax_number": "918-286-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN REGIONAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWESTERN REGIONAL HOSPITAL",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "DUFOUR",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "918-286-5370"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "2-5010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Attn: Pharmacy and Nutrition Shoppe",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Southside Dermatology PLLC
• Southwest Neurology Specialist LLC
• Southwest Pathology Associates LLC
• Southwest Pathology, Inc
• Southwest Therapry Consultants
• Southwestern Regional Medical Center, LLC
• Stephanie P Souvannachak-Cowick, OD
• Shannon Kathleen Sova, DPT
• Emily Anyeley Sowah
• Kristina Sowards, OTR/L

• Community/Retail Pharmacy in Tulsa, OK
• Providers in Tulsa, 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 Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.