HERITAGE PARK PHARMACY, LLC (NPI# 1619194453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619194453 |
| Entity Type | Organization |
| Organization Name | HERITAGE PARK PHARMACY, LLC |
| Practice Address |
6908 E Reno Ave Ste 101 Midwest City OK 73110-2120 |
| Practice Telephone | 4057376697 |
| Practice Fax Number | 4057376698 |
| Mailing Telephone | 4057376697 |
| Mailing Fax Number | 4057376698 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2014-01-30 |
| Authorized Official Name | CHERYL MARIE DESJARDINS (OWNER) |
| Authorized Official Telephone | 4057376697 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | T-6052 | OK | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | NCPDP | 3713218 | 01 |
| OK | 100237240A | 05 |
| Street Address |
6908 E RENO AVE STE 101 |
| City | MIDWEST CITY |
| State | OK |
| Zip Code | 73110-2120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255939377 | Torry E Elston | Technician/Technologist | 5908 Se 15th St, Midwest City, OK 73110 | 2020-10-12 |
| 1083225783 | Daniel B Nguyen | Pharmacist | 1601 S Air Depot, Midwest City, OK 73110 | 2020-08-14 |
| 1114494903 | Tiandrea Jeanae Neal | Behavioral Analyst | 1212 S. Air Depot, Ste 17, Midwest City, OK 73110 | 2018-10-30 |
| 1467902593 | Brian Christopher Lewis | Case Manager/Care Coordinator | 8616 Cedar Ridge Drive, Midwest City, OK 73110 | 2016-10-13 |
| 1669839312 | National Iom, Pllc | Electrodiagnostic Medicine | 1205 S. Air Depot # 102, Midwest City, OK 73110 | 2016-01-26 |
| 1003292210 | Alexandrea Funston | Speech-Language Pathologist | 224 E Blossom Drive, Midwest City, OK 73110 | 2015-08-11 |
| 1184053399 | Ronya Caraway | Community/Behavioral Health | 7901 Ne 10th, B106, Midwest City, OK 73110 | 2013-11-07 |
| 1245678374 | Layfette Lamar Fletcher | Counselor | 405 Delia Street, Midwest City, OK 73110 | 2013-06-11 |
| 1114364163 | Kathryn Ann Gray | Social Worker | 1391 North Midwest Blvd., Midwest City, OK 73110 | 2013-05-31 |
| 1841542545 | Steven Atkins Akinnfest | Counselor | 417 Reed Place, Midwest City, OK 73110 | 2012-10-05 |
| Find all providers in zip 73110 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083223911 | Lindsey Brelynn Pulchny | Pharmacy Technician | 744 S Mississippi Ave Ste A, Atoka, OK 74525-3356 | 2020-07-27 |
| 1396243580 | Linda Joann Falling | Pharmacy Technician | 1500 E Downing St Ste 106, Tahlequah, OK 74464-3354 | 2018-01-23 |
| 1598140816 | Austin Scott Klososky | Pharmacy Technician | 13301 S Pennsylvania Ave, Oklahoma City, OK 73170-5007 | 2015-07-28 |
| 1992184436 | Veronica Lavon Austin | Pharmacy Technician | 6305 Ne 63rd St, Oklahoma City, OK 73141-9681 | 2015-05-28 |
| 1679653570 | Gayle Clark | Pharmacy Technician | 815 E 6th Street, Tishomingo, OK 73460 | 2006-10-16 |
| 1134210016 | Mechelle Lynnette Bentley | Pharmacy Technician | 301 West Grand, Tonis Westside Pharmacy, Ponca City, OK 74601 | 2006-09-27 |
| 1619068426 | Tiffany A Buckley | Pharmacy Technician | 4734 S 252nd West Ave, Sand Springs, OK 74063-4319 | 2006-09-27 |
| 1538260872 | Shaun E Swartz II | Pharmacy Technician | 1603 West 14th, Sulphur, OK 73086 | 2006-09-26 |
| 1679677959 | Anita Lynnette Reynolds | Pharmacy Technician | 116 S Wilson, Vinita, OK 74301 | 2006-09-08 |
| 1285666115 | Rebecca Louise Whatley | Pharmacy Technician | 205 S Park Ln Ste 110, Altus, OK 73521-5733 | 2006-07-07 |
| Find all providers with the same taxonomy | ||||
| City | MIDWEST CITY |
| Zip Code | 73110 |
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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.