Sooner Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

55-3551 Issued in OK

Legal business name

SOONER PHARMACY

Practice address

815 W Broadway Ave
Sulphur, OK 73086-4611

Phone

(580) 622-2208

Fax

(580) 622-2200

NPI assigned

Aug 26, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Ray Pittman, PHARM D, PHDNPI 1154428696

Title

Owner/Pharmacist

Phone

(580) 622-2208

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Sooner Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sooner Pharmacy

  • Pharmacist
  • Sulphur, OK
  • NPI 1699858134
  NPD tax ID

Practitioners 1

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.

• David R Pittman, RPH

  • Pharmacist
  • Sulphur, OK
  • NPI 1154428696
  Authorized official Same address or phone

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861485559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W BROADWAY AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864611",
            "telephone_number": "580-622-2208",
            "fax_number": "580-622-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W BROADWAY AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864611",
            "telephone_number": "580-622-2208",
            "fax_number": "580-622-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOONER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "580-622-2208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D, PHD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OK",
            "license": "55-3551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3703128",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Cody Shaeffer, PHARM.D.
• Tracy Shivers
• Stacey Lynn Smith
• Sole'Renity Spa, Inc.
• Sooner Pharmacy
• Sooner Pharmacy of Oklahoma LLC
• Southeastern Oklahoma Family Services, Inc.
• Southern Oklahoma Eye Center LLC
• Southern Oklahoma Treatment Services (OK Behavioral Health)
• State of Oklahoma (Sulphur Veterans Center)

• Pharmacy in Sulphur, OK
• Providers in Sulphur, OK by specialty
• Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.