Active NPI
Amru Omar Elayan, PHARMD
- Pharmacist
- Oklahoma City, OK
National Provider Identifier
1801509203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19903
- Practice address
- 4400 NW 23Rd St
Oklahoma City, OK 73107-2644 - Phone
- (405) 943-9899
- NPI assigned
- Dec 30, 2022
- Last updated
- Dec 30, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | 19903 | OK | Primary |
Addresses
Primary practice location
4400 NW 23Rd St
Oklahoma City, OK 73107-2644
Mailing address
5309 Long Branch LN
Edmond, OK 73034-7948
Phone (423) 794-9088
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19903 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672358400000",
"number": "1801509203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5309 LONG BRANCH LN",
"city": "EDMOND",
"state": "OK",
"postal_code": "730347948",
"telephone_number": "423-794-9088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 NW 23RD ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731072644",
"telephone_number": "405-943-9899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELAYAN",
"first_name": "AMRU",
"middle_name": "OMAR",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-12-30",
"last_updated": "2022-12-30",
"certification_date": "2022-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "19903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.