United Discount Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

176355 Issued in OK

Legal business name

UNITED DISCOUNT DRUG INC

Practice address

601 E Broadway St
Altus, OK 73521-5512

Phone

(580) 477-0800

Fax

(580) 477-0802

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Terra Brooks

Title

Pharmacy Manager

Phone

(580) 477-0800

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Broadway Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1952483752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E BROADWAY ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735215512",
            "telephone_number": "580-477-0800",
            "fax_number": "580-477-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E BROADWAY ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735215512",
            "telephone_number": "580-477-0800",
            "fax_number": "580-477-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DISCOUNT DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "TERRA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "580-477-0800"
    },
    "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": "176355",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100234180A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100234180B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2072623",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Tran, DO
• Kyanna Tripp
• Ashley Taylor Turner
• Eteakamba J Udoh, MD
• United Discount Drug
• Rhonda E Valdez, LCSW
• Valir Outpatient Clinic #6 LLC
• Valir Outpatient Clinics LLC
• Steven C Vaughan, DPH
• Brandy Jo Vermillion, APRN-CNP

• All providers in Altus, OK
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.