Organization Active NPI

C & B Pharmacy Inc

Doing business as Hospital Discount Pharmacy

  • Community/Retail Pharmacy
  • Edmond, OK
National Provider Identifier
1790823789
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1-1634 Issued in OK
Legal business name
C & B PHARMACY INC
Doing business as
Hospital Discount Pharmacy
Practice address
104 S Bryant Ave
Edmond, OK 73034-6327
Phone
(405) 348-1677
Fax
(405) 359-9040
NPI assigned
Feb 2, 2007
Last updated
Jan 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Authorized official

Name
Shannon MartinNPI 1457839185
Title
Pharmacist
Phone
(405) 348-1677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 1-1634 OK Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

104 S Bryant Ave
Edmond, OK 73034-6327

Mailing address

104 S Bryant Ave
Edmond, OK 73034-6327
Phone (405) 348-1677

Other identifiers 2

IdentifierTypeStateIssuer
2072541OtherPK
100234960AMedicaidOK

Other names 1

  • Hospital Discount Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080215000082 OK Part B Supplier - Mass Immunization (Roster Biller Only) 4385727247 Practice locations: Edmond, OK
O20100930050311 OK DME Supplier - Pharmacy 4385727247 Practice locations: Edmond, OK

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0904540Hospital Discount Pharmacy104 S Bryant, Edmond, OK 73034Certificate of waiverAug 21, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hospital Discount Pharmacy104 S Bryant Ave, Edmond, OK 73034-6327(405) 348-1677 Nebulizer Drugs|Ostomy Supplies Does not accept assignmentParticipating since Jan 1, 2007

National Provider Directory

National Provider Directory

Locations

104 S Bryant Ave
Edmond, OK 73034
Phone (405) 348-1677

Practitioners & affiliated clinicians

Practitioners 9

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1790823789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346327",
            "telephone_number": "405-348-1677",
            "fax_number": "405-359-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346327",
            "telephone_number": "405-348-1677",
            "fax_number": "405-359-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C & B PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "405-348-1677"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "1-1634",
            "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": "2072541",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100234960A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospital Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.