GRANITE DRUG, INC (NPI# 1295804920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295804920 |
| Entity Type | Organization |
| Organization Name | GRANITE DRUG, INC |
| Other Organization Name | GRANITE DRUG STORE |
| Practice Address |
316 Main St Granite OK 73547-0158 |
| Mailing Address |
Po Box 158 Granite OK 73547-0158 |
| Practice Telephone | 5805352130 |
| Practice Fax Number | 5805352001 |
| Mailing Fax Number | 5805352001 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2015-07-23 |
| Authorized Official Name | LIONEL CROSS (PHARM IN CHARGE) |
| Authorized Official Telephone | 5805352130 |
| Authorized Official Credential | DPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
601729 | OK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100232860A | 05 | |
| PK | 2072794 | 01 |
| Other Name | Type Code |
|---|---|
| GRANITE DRUG STORE | Doing Business As Name - Organization |
| Street Address |
316 MAIN ST |
| City | GRANITE |
| State | OK |
| Zip Code | 73547-0158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508249814 | The Kids Investment Corp | Pharmacy | 316 Main St, Granite, OK 73547-0158 | 2015-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063068385 | Murray Drug Co. LLC | Pharmacy | 316 North Main St, Granite, OK 73547 | 2019-08-13 |
| 1700168366 | Greer County Independent School District #3 | Local Education Agency (LEA) | 507 West Sixth Street, Granite, OK 73547 | 2011-09-09 |
| 1285897108 | Robert L Bernard | Physician Assistant | 1700 E 1st Street, Granite, OK 73547 | 2008-07-10 |
| 1396911830 | N Evans Einterprises LLC | Physician Assistant | 417 N. Main, Granite, OK 73547 | 2008-05-05 |
| 1184848830 | Robert Louis Albright | Dentist | 1701 East First Street, Granite, OK 73547 | 2007-04-12 |
| 1205928983 | Mark Anthony Evans | Physician Assistant | 417 N Main, Grainte, OK 73547 | 2006-09-29 |
| 1922147305 | Blackhawk Mangum, LLC | General Acute Care Hospital | 417 North Main St, Granite, OK 73547 | 2007-02-05 |
| 1497121974 | Tressa Brewer | Speech-Language Pathologist | 507 W 6th, Granite, OK 73547-0098 | 2015-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063068385 | Murray Drug Co. LLC | Pharmacy | 316 North Main St, Granite, OK 73547 | 2019-08-13 |
| 1497121974 | Tressa Brewer | Speech-Language Pathologist | 507 W 6th, Granite, OK 73547-0098 | 2015-08-19 |
| 1972863769 | Rebecca Douglass | Acupuncturist | 10109 Davis Ave, Granite, MD 21163-1226 | 2012-05-25 |
| 1700168366 | Greer County Independent School District #3 | Local Education Agency (LEA) | 507 West Sixth Street, Granite, OK 73547 | 2011-09-09 |
| 1285897108 | Robert L Bernard | Physician Assistant | 1700 E 1st Street, Granite, OK 73547 | 2008-07-10 |
| 1396911830 | N Evans Einterprises LLC | Physician Assistant | 417 N. Main, Granite, OK 73547 | 2008-05-05 |
| 1184848830 | Robert Louis Albright | Dentist | 1701 East First Street, Granite, OK 73547 | 2007-04-12 |
| 1922147305 | Blackhawk Mangum, LLC | General Acute Care Hospital | 417 North Main St, Granite, OK 73547 | 2007-02-05 |
| 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 |
|---|---|---|---|---|
| 1063068385 | Murray Drug Co. LLC | Pharmacy | 316 North Main St, Granite, OK 73547 | 2019-08-13 |
| 1508249814 | The Kids Investment Corp | Pharmacy | 316 Main St, Granite, OK 73547-0158 | 2015-07-06 |
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|---|---|---|---|---|
| 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 |
| 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 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
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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.