WENDELL FULLER (NPI# 1053761056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053761056 |
| Entity Type | Individual |
| Full Name | WENDELL FULLER |
| Credential | PHARM.D. |
| Practice Address |
4149 Highline Blvd Suite 300 Oklahoma City OK 73108-2103 |
| Practice Telephone | 8009409963 |
| Practice Fax Number | 8669621782 |
| Mailing Telephone | 8009409963 |
| Mailing Fax Number | 8669621782 |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 13645 | OK | Pharmacy Service Providers |
| Street Address |
4149 HIGHLINE BLVD SUITE 300 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73108-2103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760503361 | Cherie Denise Box | Counselor | 4149 Highline Blvd, Oklahoma City, OK 73108-2103 | 2007-04-02 |
| 1962980615 | Danielle Hayes Reseck | Student in an Organized Health Care Education/Training Program | 4149 Highline Blvd, Oklahoma City, OK 73108-2103 | 2018-08-04 |
| 1467960229 | Jacquira Dillard | Peer Specialist | 4149 Highline Blvd, Oklahoma City, OK 73108-2103 | 2018-01-16 |
| 1295185205 | Donya Cuff | Pharmacy Technician | 4149 Highline Blvd, Suite 300, Oklahoma City, OK 73108-2103 | 2016-06-21 |
| 1619313954 | Southern Oklahoma Treatment Services, Inc | Community/Behavioral Health | 4149 Highline Blvd, Suite 400, Oklahoma City, OK 73108-2103 | 2013-05-14 |
| 1700221843 | Southeastern Oklahoma Family Services, Inc | Community/Behavioral Health | 4149 Highline Blvd, Suite 390,400, Oklahoma City, OK 73108-2103 | 2013-05-02 |
| 1962846733 | Terrance Mitchell | Counselor | 4149 Highline Blvd, Suite 390, Oklahoma City, OK 73108-2103 | 2013-04-24 |
| 1114266442 | Melanie A Morriss | Counselor | 4149 Highline Blvd, Suite 390, Oklahoma City, OK 73108-2103 | 2013-02-06 |
| 1639413156 | Andre Daughty | Counselor | 4149 Highline Blvd, Suite 390,400, Oklahoma City, OK 73108-2103 | 2012-11-21 |
| 1033462205 | Dominic Carter | Counselor | 4149 Highline Blvd, Oklahoma City, OK 73108-2103 | 2012-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316477714 | Dionna Danielle Weixel | Counselor | 4341 Will Rogers Parkway, Oklahoma City, OK 73108 | 2017-06-18 |
| 1497205389 | Amber Croom | Case Manager/Care Coordinator | 909 S Meridian Ave Ste 525, Oklahoma City, OK 73108 | 2016-10-04 |
| 1063837524 | Bobby King | Counselor | 401 46th St., Oklahoma City, OK 73108 | 2014-02-20 |
| 1104167816 | Chad Jeffrey Perry | Physical Therapy Assistant | 238 Quadrum Drive, Oklahoma City, OK 73108 | 2013-03-05 |
| 1295071918 | Avalon Corrections | Case Management | 400 S. May, Oklahoma City, OK 73108 | 2012-12-28 |
| 1164608790 | American Current Care P.a. | Clinic/Center | 200 Quadrum Drive, Oklahoma City, OK 73108 | 2008-01-14 |
| 1790960672 | Fresh Start Counseling Services Inc | Community/Behavioral Health | 4801 Classen Boulevard, Suite 159, Oklahoma City, OK 73108 | 2008-01-09 |
| 1366644577 | Saints Medical Group, LLC | Physician Assistant | 2401 Sw 23rd St, Suite 101, Oklahoma City, OK 73108 | 2007-06-01 |
| 1902027287 | Joel William Corn | Family Medicine | 1506 S Agnew, Okha City, OK 73108 | 2007-05-02 |
| 1851493944 | Good Shepherd Hospice Inc | Hospice Care, Community Based | 4350 Will Rogers Parkway, Suite 400, Oklahoma City, OK 73108 | 2006-09-01 |
| Find all providers in zip 73108 | ||||
| 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 |
|---|---|---|---|---|
| 1023618360 | Michelle Lam | Pharmacist | 1500 Sw 59th St # At, Oklahoma City, OK 73119-7214 | 2020-10-27 |
| 1871108902 | Kayley Jordan | Pharmacist | 701 W Hefner Rd, Oklahoma City, OK 73114-6836 | 2020-09-15 |
| 1053925735 | Jennie Nguyen | Pharmacist | 519 Nw 23rd St Ste 109, Oklahoma City, OK 73103-1509 | 2020-09-01 |
| 1811527294 | Tara Ann Dominguez | Pharmacist | 3116 Nw 21st St, Oklahoma City, OK 73107-3010 | 2020-01-24 |
| 1730739871 | Calven Ngo | Pharmacist | 4301 S May Ave, Oklahoma City, OK 73119-3275 | 2019-09-19 |
| 1134776891 | Talitha Joy Nichols | Pharmacist | 390 Ne 36th St, Oklahoma City, OK 73105-2508 | 2019-08-19 |
| 1710531595 | Dillon Hayden | Pharmacist | 1122 Ne 13th St Ste 4201c, Oklahoma City, OK 73117-1039 | 2019-07-30 |
| 1225509904 | Liza Ann Martinez | Pharmacist | 3433 Nw 56th St Ste 140b, Oklahoma City, OK 73112-4430 | 2018-12-06 |
| 1215406962 | Jonathan Patrick Hanna | Pharmacist | 11101 Hefner Pointe Dr Ste 101, Oklahoma City, OK 73120-5054 | 2018-11-23 |
| 1689188310 | Bryan Ticer | Pharmacist | 825 Ne 10th St Ste 2a, Oklahoma City, OK 73104-5417 | 2017-11-16 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73108 |
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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.