Ada Apothecary PLLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

237302 Issued in OK

Legal business name

ADA APOTHECARY PLLC

Practice address

1201B Arlington St
Ada, OK 74820-4072

Phone

(580) 332-2000

Fax

(580) 332-2004

NPI assigned

Aug 3, 2015

Organization subpart

No

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

Authorized official

Name

Beverly Smith

Title

Pic

Phone

(405) 990-0666

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Ada Apothecary Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 2

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

• Beverly CS Bates, PHARM.D.

  • Pharmacist
  • Ada, OK
  • NPI 1326568924
  NPD
• Kimethria Laurie Jackson, MSN, ARNP

  • Family Nurse Practitioner
  • Ada, OK
  • NPI 1962441170
  NPD (past)

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1831575752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201B ARLINGTON ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204072",
            "telephone_number": "580-332-2000",
            "fax_number": "580-332-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201B ARLINGTON ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204072",
            "telephone_number": "580-332-2000",
            "fax_number": "580-332-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA APOTHECARY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "405-990-0666"
    },
    "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": "237302",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151917",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ada Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Bailey Lane Ackerman, MSW
• Ada Acupuncture Clinic, TCM and Pain LLC
• Ada Anesthesia Associates, PLLC
• Ada Area Chemical Dependency Center, Inc
• Ada Area Youth Shelter Inc.
• Ada Artificial Limb & Brace Inc.
• Ada Care Center LLC
• Ada City Schools

• All providers in Ada, OK
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.