Bunker Hill Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

17-5510 Issued in OK

Legal business name

BUNKER HILL PHARMACY INC

Doing business as

Bunker Hill Pharmacy

Practice address

1610 N Main St
Altus, OK 73521-2145

Phone

(580) 482-7530

Fax

(580) 482-9139

NPI assigned

Sep 30, 2006

Last updated

Nov 18, 2015By 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

Mark Dodson

Title

Pharmacist

Phone

(580) 482-7530

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BUNKER HILL PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1861585291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 N MAIN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735212145",
            "telephone_number": "580-482-7530",
            "fax_number": "580-482-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 N MAIN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735212145",
            "telephone_number": "580-482-7530",
            "fax_number": "580-482-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUNKER HILL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "580-482-7530"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "17-5510",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2072619",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100235630A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUNKER HILL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeanne Lee Brandon, BS
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• Kimberley Ann Bryant, BS
• Dustin S Burrow, PT
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• Cherity Dawn Burrows, APRN-CNP
• Elena Bustos
• Sara Calabro, M.A., LMFT

• Community/Retail Pharmacy in Altus, OK
• Providers in Altus, 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 Nov 18, 2015; 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.