Black Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

30-4476 Issued in OK

Legal business name

BLACK DRUG INC

Doing business as

Black Drug

Practice address

412 E Main St
Locust Grove, OK 74352-5117

Phone

(918) 479-5223

Fax

(918) 479-6510

NPI assigned

Jan 16, 2007

Last updated

Sep 27, 2016By 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

Kevin Black

Title

President

Phone

(918) 479-5223

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• BLACK DRUG Doing business as

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1952452955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "LOCUST GROVE",
            "state": "OK",
            "postal_code": "743520669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 E MAIN ST",
            "city": "LOCUST GROVE",
            "state": "OK",
            "postal_code": "743525117",
            "telephone_number": "918-479-5223",
            "fax_number": "918-479-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-479-5223"
    },
    "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": "30-4476",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081532",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100232740A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLACK DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Locust Grove, OK
• Providers in Locust Grove, 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 Sep 27, 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.