Frederick Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

42-8026 Issued in OK

Legal business name

FREDERICK PHARMACY INC

Practice address

219 E Josephine Ave
Frederick, OK 73542-2017

Phone

(580) 335-7575

Fax

(580) 335-7577

NPI assigned

Sep 15, 2017

Organization subpart

No

Name

Shane Kelly, DPH

Title

Secretary

Phone

(580) 335-5501

Tax ID family

Frederick Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Frederick Pharmacy Inc

  • Community/Retail Pharmacy
  • Frederick, OK
  • NPI 1982778379
  NPD tax ID
• Frederick Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Frederick, OK
  • NPI 1356456156
  NPD tax ID

• Health Express Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2025.

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1740709252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 981",
            "city": "FREDERICK",
            "state": "OK",
            "postal_code": "735420981",
            "telephone_number": "580-335-5501",
            "fax_number": "580-335-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E JOSEPHINE AVE",
            "city": "FREDERICK",
            "state": "OK",
            "postal_code": "735422017",
            "telephone_number": "580-335-7575",
            "fax_number": "580-335-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "580-335-5501",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "42-8026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200008420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• County of Tillman-City of Frederick Hospital Authority
• County of Tillman-City of Frederick Memorial Hospital
• Calli Jewell Denny, PA
• Christine Farrone
• Frederick Eye Care PLLC
• Frederick Pharmacy Inc
• Frederick Pharmacy, Inc.
• Full Circle Therapy
• Patricia Ann Gaffney
• Teresa Dianne Gant, CASE MANAGER

• All providers in Frederick, 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, 2025; 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.