DONOVAN FULLER (NPI# 1972103299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972103299 |
| Entity Type | Individual |
| Full Name | DONOVAN FULLER |
| Credential | PHARMD |
| Practice Address |
1117 W I 35 Frontage Rd Edmond OK 73034-7398 |
| Practice Telephone | 4057573802 |
| Practice Fax Number | 4057573251 |
| Mailing Telephone | 4057573802 |
| Mailing Fax Number | 4057573251 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | PD12183 | AR | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 14472 | OK | Pharmacy Service Providers |
| Street Address |
1117 W I 35 FRONTAGE RD |
| City | EDMOND |
| State | OK |
| Zip Code | 73034-7398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705595 | Sam's East, Inc. | Technician/Technologist | 1117 W I 35 Frontage Rd, Edmond, OK 73034-7398 | 2019-11-25 |
| 1235739970 | Ha Le Tran | Pharmacist | 1117 W I 35 Frontage Rd, Edmond, OK 73034-7398 | 2020-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104099 | James R Hargis | Pharmacist | 1820 Rosedale Dr, Edmond, OK 73013-6638 | 2020-11-04 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1578175246 | Stefan Joseph Miranov | Pharmacist | 1308 N Bryant Ave, Edmond, OK 73034-4950 | 2020-08-23 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1033685730 | Chad Alan Caldwell | Pharmacist | 4833 Integris Pkwy Ste 130, Edmond, OK 73034-8864 | 2018-10-19 |
| 1881171528 | David L George | Pharmacist | 14101 N Eastern Ave Ste A, Edmond, OK 73013-5860 | 2018-07-25 |
| 1295270494 | Barbara Fang | Pharmacist | 3051 Willowood Rd, Edmond, OK 73034-9725 | 2016-12-23 |
| 1144625138 | Renae M Kraft | Pharmacist | 1101 Nw 178th St Ste A, Edmond, OK 73012-4281 | 2014-11-03 |
| 1255778452 | Shannan Denise Wideman | Pharmacist | 701 Fox Run Trl, Edmond, OK 73034-7360 | 2013-05-29 |
| 1922354208 | Kristen Winters | Pharmacist | 1701 Renaissance Blvd Ste 120, Edmond, OK 73013-3086 | 2012-07-24 |
| Find all providers in EDMOND | ||||
Please comment or provide details below to improve the information on DONOVAN FULLER.
| 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.