NPIMap

Organization Active NPI

Community Pharmacy LLC

  • Community/Retail Pharmacy
  • Oklahoma City, OK
National Provider Identifier
1942365879
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
15137 Issued in OK
Legal business name
COMMUNITY PHARMACY LLC
Practice address
3125 SW 89TH St
Oklahoma City, OK 73159-7901
Phone
(405) 605-7700
Fax
(405) 605-7712
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Authorized official

Name
Ed Gray
Title
Director
Phone
(405) 419-5478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 15137 OK Primary

Addresses

Primary practice location

3125 SW 89TH St
Oklahoma City, OK 73159-7901

Mailing address

3125 SW 89TH St
Oklahoma City, OK 73159-7901

Other identifiers 1

IdentifierTypeStateIssuer
3724754OtherOTHER ID NUMBER

Other names 1

  • FOUNTAIN PARK PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Pharmacy LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1942365879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 SW 89TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 SW 89TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597901",
            "telephone_number": "405-605-7700",
            "fax_number": "405-605-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "405-419-5478"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "15137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3724754",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOUNTAIN PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.