Active NPI
Annette De Santiago
- Pharmacist
- Guymon, OK
National Provider Identifier
1801375761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17864
- Practice address
- 2600 N Highway 64
Guymon, OK 73942-2751 - Phone
- (580) 338-1312
- NPI assigned
- Aug 11, 2018
- Last updated
- Aug 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17864 | OK | Primary |
Addresses
Primary practice location
2600 N Highway 64
Guymon, OK 73942-2751
Mailing address
917 S Lelia St
Guymon, OK 73942-5731
Phone (580) 302-2837
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Wal-Mart Pharmacy 10-1437
- Community/Retail Pharmacy
- Guymon, OK
- NPI 1306863428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533945600000",
"number": "1801375761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 S LELIA ST",
"city": "GUYMON",
"state": "OK",
"postal_code": "739425731",
"telephone_number": "580-302-2837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 N HIGHWAY 64",
"city": "GUYMON",
"state": "OK",
"postal_code": "739422751",
"telephone_number": "580-338-1312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE SANTIAGO",
"first_name": "ANNETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-11",
"last_updated": "2018-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "17864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guymon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.