PAWNEE HILLCREST PHARMACY ENTERPRISES, LLC (NPI# 1003909441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003909441 |
| Entity Type | Organization |
| Organization Name | PAWNEE HILLCREST PHARMACY ENTERPRISES, LLC |
| Other Organization Name | PAWNEE HILLCREST PHARMACY INC. |
| Practice Address |
539 6th Street Pawnee OK 74058-2542 |
| Practice Telephone | 9187623666 |
| Practice Fax Number | 9187622288 |
| Mailing Telephone | 9187623666 |
| Mailing Fax Number | 9187622288 |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2019-02-28 |
| Authorized Official Name | MRS. BROOKE LYNN TATUM (OWNER/PHARMACIST) |
| Authorized Official Telephone | 9187623666 |
| Authorized Official Credential | DPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
522742 | OK | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2073056 | 01 | |
| OK | 100238450A | 05 |
| Other Name | Type Code |
|---|---|
| PAWNEE HILLCREST PHARMACY | Doing Business As Name - Organization |
| Pawnee Hillcrest Pharmacy Inc. | Former Legal Business Name - Organization |
| Street Address |
539 6TH STREET |
| City | PAWNEE |
| State | OK |
| Zip Code | 74058-2542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316214430 | Tonya L Houston | Nurse Practitioner | Pawnee Indian Health Center, 1201 Heritage Cir, Pawnee, OK 74058 | 2011-11-17 |
| 1659662153 | Christie Factor | Counselor | 540 Illinois, Pawnee, OK 74058 | 2011-05-02 |
| 1366476368 | Henry J Kaehler Jr Dds PC | Clinic/Center | 401 Forest St, Pawnee, OK 74058 | 2006-07-10 |
| 1003892621 | Brady Gene Englestead | Pediatrics | 1201 Heritage Circle, Pawnee, OK 74058 | 2005-12-15 |
| 1598039620 | Cah Acquisition Company 12 LLC | Clinic/Center | 535 6th St, Pawnee, OK 74058 | 2012-03-07 |
| 1639453665 | Creoks Mental Health Services | Community/Behavioral Health | 540 Illinois St, Pawnee, OK 74058 | 2011-10-10 |
| 1659473080 | Henry John Kaehler Jr. | Dentist | 401 Forest St, Pawnee, OK 74058 | 2006-09-05 |
| 1578503611 | William Lester Carruth | Dentist | 481 Agency Road, Pawnee, OK 74058-0130 | 2006-06-07 |
| 1821275744 | Patsy Ann Cooper | Counselor | 540 Illinois St, Pawnee, OK 74058-2036 | 2008-01-22 |
| 1225158314 | Cockrell Eyecare Center | Optometrist | 534 Illinois St, Pawnee, OK 74058-2036 | 2007-03-30 |
| Find all providers in zip 74058 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376860254 | Harrys Pharmacy Inc | Pharmacy | 707 Carroll St Ste B, Pawnee, IL 62558-9661 | 2010-04-30 |
| 1720200223 | Community Drug, Inc. | Pharmacy | 609 Douglas, Pawnee, IL 62558-0619 | 2007-05-03 |
| 1497826416 | Pawnee Drug Company | Pharmacy | 553 Harrison St, Pawnee, OK 74058-2566 | 2006-11-13 |
| 1588939896 | Pawnee Drug, L.L.C. | Pharmacy | 553 Harrison St, Pawnee, OK 74058-2566 | 2012-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968958 | Westville Drug Company LLC | Pharmacy | 301 S. Williams St, Westville, OK 74965-7496 | 2020-10-08 |
| 1245843796 | Creek Nation Hospital & Clinics | Pharmacy | 1000 Riverwalk Ter, Jenks, OK 74037-5666 | 2020-08-25 |
| 1104451095 | Oklahoma Specialty Pharmacy,llc | Pharmacy | 13921 N Meridian Ave Ste 102, Oklahoma City, OK 73134-1103 | 2020-03-11 |
| 1437797248 | Oxford Pharmacy LLC | Pharmacy | 6001 S Sooner Rd Ste B, Oklahoma City, OK 73135-5601 | 2019-12-12 |
| 1952946022 | The Children's Center, Inc. | Pharmacy | 6770 Nw 39th Expy, Bethany, OK 73008-2646 | 2019-11-13 |
| 1174179154 | Lone Grove Pharmacy LLC | Pharmacy | 45 Almond Dr, Ardmore, OK 73401-2405 | 2019-08-14 |
| 1063068385 | Murray Drug Co. LLC | Pharmacy | 316 North Main St, Granite, OK 73547 | 2019-08-13 |
| 1962063933 | Walgreen Co | Pharmacy | 1145 S Utica Ave Ste G1, Tulsa, OK 74104-4022 | 2019-06-21 |
| 1760040943 | Neighborhood Pharmacy,llc | Pharmacy | 3122 N May Ave, Oklahoma City, OK 73112-6942 | 2019-06-03 |
| 1811553423 | Sequoyah County Drug Company Pllc | Pharmacy | 806 Campbell Rd Ste B, Warner, OK 74469-5008 | 2019-05-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.