Grinnell Prescription Shop Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

413479 Issued in OK

Legal business name

GRINNELL PRESCRIPTION SHOP INC

Doing business as

Grinnell Prescription Shop Inc

Practice address

304 S Broadway
Hobart, OK 73651-1862

Phone

(580) 726-5613

Fax

(580) 726-3511

NPI assigned

Dec 28, 2006

Last updated

Jan 7, 2022By 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

Steve Miller, DPHNPI 1477618007

Title

Owner

Phone

(580) 726-5613

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• GRINNELL PRESCRIPTION SHOP INC Doing business as

Locations

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.

• Steve Miller, DPH

  • Pharmacist
  • Hobart, OK
  • NPI 1477618007
  NPD (past) Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1912063892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "city": "HOBART",
            "state": "OK",
            "postal_code": "736510192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S BROADWAY",
            "city": "HOBART",
            "state": "OK",
            "postal_code": "736511862",
            "telephone_number": "580-726-5613",
            "fax_number": "580-726-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRINNELL PRESCRIPTION SHOP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-726-5613",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "413479",
            "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": "2072808",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100236820A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100236820B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRINNELL PRESCRIPTION SHOP INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRINNELL PRESCRIPTION SHOP INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shanda Fesmire
• Jari J. Frazier, O.D.
• Jodi Gray
• Great Plains Youth and Family Services
• Great Plains Youth and Family Services
• Karl Edward Gubser, DDS
• Newton Truett Guthrie, DPH
• Meagan Renee Harris, M.S.
• Robin D Harris
• Courtney Hickman

• Community/Retail Pharmacy in Hobart, OK
• Providers in Hobart, 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 7, 2022; 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.