Sooner Pharmacy Inc of Tishomingo

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

61-3493 Issued in OK

Legal business name

SOONER PHARMACY INC OF TISHOMINGO

Practice address

101 S Byrd St
Tishomingo, OK 73460-2216

Phone

(580) 371-9509

Fax

(580) 371-9252

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Mike Lafevers

Title

Pres and MGR

Phone

(580) 371-9509

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SOONER PHARMACY INC OF TISHOMINGO Doing business as

Locations

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1891874566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S BYRD ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734602216",
            "telephone_number": "580-371-9509",
            "fax_number": "580-371-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S BYRD ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734602216",
            "telephone_number": "580-371-9509",
            "fax_number": "580-371-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOONER PHARMACY INC OF TISHOMINGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "LAFEVERS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRES AND MGR",
        "authorized_official_telephone_number": "580-371-9509"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "61-3493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3714575",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100238360A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOONER PHARMACY INC OF TISHOMINGO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sheri Slaughter
• Whitney Slover, M.A., CCC-SLP
• Cameron C Smith, APRN-CNP
• Carey Smith
• Shawnna Smith, RN
• Southeastern Oklahoma Family Services, Inc
• Southern Oklahoma Treatment Services, Inc
• Southern Oklahoma Treatment Services, Inc.
• Southern Oklahoma Treatment Services, Inc.
• Southern Oklahoma Treatment Services, Inc.

• Community/Retail Pharmacy in Tishomingo, OK
• Providers in Tishomingo, 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 Feb 7, 2011; 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.