NPIMap

Organization Active NPI

Hometown Iga Pharmacy

  • Pharmacist
  • Oklahoma City, OK
National Provider Identifier
1952515140
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9854 Issued in OK
Legal business name
HOMETOWN IGA PHARMACY
Practice address
2001 NE 23Rd
Oklahoma City, OK 73111
Phone
(405) 424-4361
Fax
(405) 424-4362
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Dr. Leslie F Goodman, DR
Title
Pharmacy Manager
Phone
(405) 424-4361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 9854 OK Primary

Addresses

Primary practice location

2001 NE 23Rd
Oklahoma City, OK 73111

Mailing address

2001 NE 23Rd
Oklahoma City, OK 73111
Phone (405) 424-4361

Other identifiers 1

IdentifierTypeStateIssuer
3715200OtherOKPHARMACY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1952515140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 NE 23RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73111",
            "telephone_number": "405-424-4361",
            "fax_number": "405-424-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 NE 23RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73111",
            "telephone_number": "405-424-4361",
            "fax_number": "405-424-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN IGA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "405-424-4361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "9854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "3715200",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 19, 2008; 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.