Sooner Drug and Gifts Or Okemah

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

512948 Issued in OK

Legal business name

SOONER DRUG AND GIFTS OR OKEMAH

Practice address

324 W Broadway St
Okemah, OK 74859-2608

Phone

(918) 623-1771

Fax

(918) 623-0238

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Bernie WyattNPI 1245384361

Title

Owner

Phone

(918) 623-1036

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SOONER DRUG Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bernie B Wyatt

  • Pharmacist
  • Okemah, OK
  • NPI 1245384361
  NPD (past) Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1821154709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W BROADWAY ST",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "748592608",
            "telephone_number": "918-623-1771",
            "fax_number": "918-623-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W BROADWAY ST",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "748592608",
            "telephone_number": "918-623-1771",
            "fax_number": "918-623-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOONER DRUG AND GIFTS OR OKEMAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "BERNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-623-1036"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "512948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2073031",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100239620A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOONER DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Schmidlkofer, RN
• Michelle Renee Scott, BSW
• Angela D Shandy, MSW, LCSW
• Madyson Sharp
• Jamie Solie, LPC
• Justine Staggs, DC
• Kellyann Taron, BHRS
• Emily Ann Taylor
• Texoma Medical Services Inc
• Donald Lee Thomas, REHAB SPECIALIST

• Community/Retail Pharmacy in Okemah, OK
• Providers in Okemah, 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 26, 2016; 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.