Pharmology Bristow LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

11-5374 Issued in OK

Legal business name

PHARMOLOGY BRISTOW LLC

Practice address

201 E 7TH Ave
Bristow, OK 74010-2503

Phone

(918) 367-3328

Fax

(918) 367-2415

NPI assigned

Sep 30, 2006

Organization subpart

No

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

Authorized official

Name

Matthew Fin

Title

Officer

Phone

(469) 261-3048

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SUPER H PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Van Hodges, PHARMD

  • Pharmacist
  • Bristow, OK
  • NPI 1487261434
  NPD
• Rochelle Elaine Landreth, PHARMD

  • Pharmacist
  • Blanchard, OK
  • NPI 1588248876
  NPD (past)
• Letha Virginia Ray, D.PH.

  • Pharmacist
  • Bristow, OK
  • NPI 1205930245
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537315200000",
    "number": "1720171168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 7TH AVE",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102503",
            "telephone_number": "918-367-3328",
            "fax_number": "918-367-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 7TH AVE",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102503",
            "telephone_number": "918-367-3328",
            "fax_number": "918-367-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMOLOGY BRISTOW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2018-09-19",
        "status": "A",
        "authorized_official_last_name": "FIN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "469-261-3048"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "11-5374",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100236210A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2073744",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPER H PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SUPER H PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Norwood, CPM
• Osu Center for Health Sciences
• Outside the Box Speech Services, LLC
• Angi Palmer-Manire, APRN, DNP, FNP-C
• Jay Wade Pettit, D.D.S.
• Physicians Choice Dialysis of Bristow LLC
• Physicians Pathology Inc
• Kaley Pieratt
• Sarah Brooke Pinson, P.A.
• Rainbow Health Care

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.