Ken's Healthmart LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8-2834 Issued in OK

Legal business name

KEN'S HEALTHMART LLC

Doing business as

Kens Healthmart Pharmacy LLC

Practice address

200 S Highland Ave
Cushing, OK 74023-4117

Phone

(918) 225-5200

Fax

(918) 225-0828

NPI assigned

Sep 30, 2006

Organization subpart

No

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

Authorized official

Name

Ken Hibbard, RPH

Title

Owner

Phone

(918) 225-5200

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• KENS HEALTHMART PHARMACY LLC Doing business as

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1902999345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S HIGHLAND AVE",
            "city": "CUSHING",
            "state": "OK",
            "postal_code": "740234117",
            "telephone_number": "918-225-5200",
            "fax_number": "918-225-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S HIGHLAND AVE",
            "city": "CUSHING",
            "state": "OK",
            "postal_code": "740234117",
            "telephone_number": "918-225-5200",
            "fax_number": "918-225-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEN'S HEALTHMART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "HIBBARD",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-225-5200",
        "authorized_official_credential": "RPH"
    },
    "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": "8-2834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2073600",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100235560A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KENS HEALTHMART PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alli Ivory, PTA
• Nancy Rotz Jackson, M.S.OTR/L
• Bethaney Buddilyn Jenkins, ARNP
• Joanne Kaplan, L.C.S.W.
• Cheryl Kelly, P.T.
• Premal Khetia, MD
• Sterling Elizabeth Koehn, DPT
• Peter Lafon, DO
• Sarah Laird, APRN-CNP
• Rod Lancaster, PHARM.D.

• Community/Retail Pharmacy in Cushing, OK
• Providers in Cushing, 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 Jan 13, 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.