NPIMap

Organization Active NPI

Flourish Integrative Pharmacy LLC

Doing business as Flourish Pharmacy

  • Community/Retail Pharmacy
  • Oklahoma City, OK
National Provider Identifier
1770647109
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1-6316 Issued in OK
Legal business name
FLOURISH INTEGRATIVE PHARMACY LLC
Doing business as
Flourish Pharmacy
Practice address
14720 N Pennsylvania Ave
Oklahoma City, OK 73134-6120
Phone
(405) 751-3333
Fax
(405) 751-3848
NPI assigned
Dec 20, 2006
Last updated
Jan 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Jerrod Roberts, DPHNPI 1255342424
Title
Owner
Phone
(405) 751-3333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 1-6316 OK Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

14720 N Pennsylvania Ave
Oklahoma City, OK 73134-6120

Mailing address

14720 N Penn Ave
Oklahoma City, OK 73134-6120
Phone (405) 751-3333

Other identifiers 1

IdentifierTypeStateIssuer
2076566OtherPK

Other names 1

  • FLOURISH PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

14720 N Pennsylvania Ave
Oklahoma City, OK 73134
Phone (405) 751-3333

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1770647109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14720 N PENN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346120",
            "telephone_number": "405-751-3333",
            "fax_number": "405-751-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14720 N PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346120",
            "telephone_number": "405-751-3333",
            "fax_number": "405-751-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOURISH INTEGRATIVE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JERROD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-751-3333",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "1-6316",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2076566",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLOURISH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.