MR. WYATT EVANS LIVELY (NPI# 1679126627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679126627 |
| Entity Type | Individual |
| Full Name | MR. WYATT EVANS LIVELY |
| Credential | D.PH. |
| Practice Address |
128 E Cherokee Ave Nowata OK 74048-2702 |
| Practice Telephone | 9182733825 |
| Practice Fax Number | 9182732251 |
| Mailing Telephone | 9182733825 |
| Mailing Fax Number | 9182732251 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
18327 | OK | Suppliers |
| Street Address |
128 E CHEROKEE AVE |
| City | NOWATA |
| State | OK |
| Zip Code | 74048-2702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952471039 | The City Drug, Inc. | Pharmacy | 128 E Cherokee Ave, Nowata, OK 74048-2702 | 2006-11-08 |
| 1801447941 | The City Drug, Inc. | Pharmacy | 128 E Cherokee Ave, Nowata, OK 74048-2702 | 2019-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647142 | Lacey Catherine Woolman | Case Manager/Care Coordinator | 114 W. Deleware Ave, Nowata, OK 74048 | 2020-07-27 |
| 1891261095 | Kristina E Edens | Counselor | 114 W Deleware, Nowata, OK 74048 | 2018-10-16 |
| 1497247142 | Dustin James Lang | Counselor | 111 W Deleware, Nowata, OK 74048 | 2018-05-30 |
| 1679011928 | Melanie Jane Cline | Counselor | 114 West Delaware, Nowata, OK 74048 | 2017-02-07 |
| 1063955276 | Rebecca A Kidwell | Registered Nurse | 1024 Lenape Drive, Nowata, OK 74048 | 2016-11-21 |
| 1477724912 | City of Nowata Medical Trust Authority | Ambulance | 425 S. Cedar, Nowata, OK 74048 | 2008-03-12 |
| 1023238235 | Charles F Danley | Counselor | 114 W Delaware, Nowata, OK 74048 | 2007-04-27 |
| 1730221177 | Robert Bruce Rickards | Dentist | 117 W Delaware Ave, Nowata, OK 74048 | 2007-02-13 |
| 1023156791 | Debra Keith | Physician Assistant | 237 S Locust, Nowata, OK 74048 | 2007-02-02 |
| 1942390406 | Harold Lowell Meister | Optometrist | 111 North Maple Street, Nowata, OK 74048 | 2006-10-13 |
| Find all providers in zip 74048 | ||||
| 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 |
|---|---|---|---|---|
| 1801447941 | The City Drug, Inc. | Pharmacy | 128 E Cherokee Ave, Nowata, OK 74048-2702 | 2019-09-20 |
| 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.