Sallisaw Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

34-3071 Issued in OK

Legal business name

SALLISAW PHARMACY INC

Practice address

1212A E Cherokee
Sallisaw, OK 74955-5231

Phone

(918) 775-4451

Fax

(918) 775-5269

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Jimmy Risley, DPH

Title

President

Phone

(918) 775-4451

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SALLISAW PHARMACY Doing business as

Practitioners 1

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

• Dakota Russell Tanner, PHARMD

  • Pharmacist
  • Sallisaw, OK
  • NPI 1952933186
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1730108770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212A E CHEROKEE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749555231",
            "telephone_number": "918-775-4451",
            "fax_number": "918-775-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212A E CHEROKEE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749555231",
            "telephone_number": "918-775-4451",
            "fax_number": "918-775-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLISAW PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "RISLEY",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-775-4451",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "34-3071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100237570A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2073858",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SALLISAW PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sallisaw Chiropractic Clinic Inc.
• Sallisaw Family Medicine, L.L.C.
• Sallisaw Medical Clinic LLC
• Sallisaw Mental Health LLC
• Sallisaw Pharmacy Inc
• Sallisaw Public School
• Sallisaw State Veterans Home
• Sallisawrx LLC
• Jeffrey S Sanders, DPH
• Rikki Jo Sanders

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.