Shawnee Regional Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

105520 Issued in OK

Legal business name

SHAWNEE REGIONAL PHARMACY INC

Doing business as

The Clinic Pharmacy

Practice address

3210 Kethley Rd
Shawnee, OK 74804-9625

Phone

(405) 273-9417

Fax

(405) 273-8849

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Timothy BarrickNPI 1598842767

Title

Owner Manager Officer

Phone

(405) 273-9417

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• THE CLINIC 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, and the practitioner matching its NPPES authorized official.

• Timothy Alan Barrick, D.PH.

  • Pharmacist
  • Shawnee, OK
  • NPI 1598842767
  Authorized official Same address or phone

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1770652257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049625",
            "telephone_number": "405-273-9417",
            "fax_number": "405-273-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049625",
            "telephone_number": "405-273-9417",
            "fax_number": "405-273-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE REGIONAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "BARRICK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER MANAGER OFFICER",
        "authorized_official_telephone_number": "405-273-9417"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "105520",
            "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": "100235610A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2073679",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE CLINIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Misty Dawn Sheldon, DDS
• Riley Shelton
• Nichole Hopkins Sherman, APRN

• Community/Retail Pharmacy in Shawnee, OK
• Providers in Shawnee, 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 May 11, 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.