Cushing Family Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8-7679 Issued in OK

Legal business name

CUSHING FAMILY PHARMACY INC

Practice address

200 S Highland Ave
Cushing, OK 74023-4117

Phone

(918) 225-5200

Fax

(918) 225-0828

NPI assigned

Jul 25, 2016

Organization subpart

No

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

Authorized official

Name

Troy Simons

Title

President

Phone

(405) 742-8099

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Cushing Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

Tax ID family

Cushing Family Pharmacy2 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.

• Cushing Family Pharmacy LTC

  • Long Term Care Pharmacy
  • Cushing, OK
  • NPI 1700520731
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Thibodeau

  • Pharmacist
  • Cushing, OK
  • NPI 1225582661
  NPD

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1942753124",
    "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": "CUSHING FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "SIMONS",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-742-8099"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "8-7679",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200663180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cushing Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cushing Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colonial Plaza Management Company LLC
• Colonial Plaza Nursing Home Inc
• Charles Cooper Jr.
• Janel Jo Cravens
• Jennifer Leigh Cuenca
• Cushing Family Pharmacy LTC
• Cushing Nursing Center, Inc
• Cushing Operations LLC
• Cushing Public Schools
• Cushing Specialist Group

• 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 Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.