FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA, INC. (NPI# 1427429687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427429687 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA, INC. |
| Other Organization Name | FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA PHARMACY |
| Practice Address |
610 E 24th St Tishomingo OK 73460-3245 |
| Practice Telephone | 5803710203 |
| Practice Fax Number | 5803710205 |
| Mailing Telephone | 5803710203 |
| Mailing Fax Number | 5803710205 |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2016-10-24 |
| Authorized Official Name | JOE DON BURNS (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 5803712343 |
| Authorized Official Credential | DPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
61-7438 | OK | Suppliers |
| Other Name | Type Code |
|---|---|
| Family Health Center of Southern Oklahoma Pharmacy | Doing Business As Name - Organization |
| Street Address |
610 E 24TH ST |
| City | TISHOMINGO |
| State | OK |
| Zip Code | 73460-3245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932141728 | Keith Gerrell Plummer | Physician Assistant | 610 E 24th St, Tishomingo, OK 73460-3245 | 2006-06-13 |
| 1285297598 | Relinda Lea Black | Nurse Practitioner | 610 E 24th St, Tishomingo, OK 73460-3245 | 2019-04-22 |
| 1013427129 | Carol Lynn Maxwell | Nurse Practitioner | 610 E 24th St, Tishomingo, OK 73460-3245 | 2017-10-03 |
| 1992233779 | Ollie Logan Beard Iv | Dentist | 610 E 24th St, Tishomingo, OK 73460-3245 | 2017-05-24 |
| 1598140212 | Family Health Center of Southern Oklahoma, Inc | Clinic/Center | 610 E 24th St, Tishomingo, OK 73460-3245 | 2015-07-23 |
| 1558741751 | Kayla Muszynski | Dentist | 610 E 24th St, Tishomingo, OK 73460-3245 | 2015-06-02 |
| 1407257942 | Jessica D Pickens | Nurse Practitioner | 610 E 24th St, Tishomingo, OK 73460-3245 | 2014-09-15 |
| 1487091047 | Shanetha Linn Collier | Dentist | 610 E 24th St, Tishomingo, OK 73460-3245 | 2013-05-22 |
| 1174862320 | Brad T Brogdon | Counselor | 610 E 24th St, Tishomingo, OK 73460-3245 | 2013-02-07 |
| 1740549344 | Jessica L Lawley | Counselor | 610 E 24th St, Tishomingo, OK 73460-3245 | 2012-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912380742 | Lori Pigg | Speech-Language Pathologist | 508 N. Neshoba, Tishomingo, OK 73460 | 2015-06-29 |
| 1407241748 | Brittany Walker | Case Management | 850 E. Highway 22, Tishomingo, OK 73460 | 2015-04-03 |
| 1427460641 | Elizabeth Mcdonald | Counselor | 512 East 24th, Tishomingo, OK 73460 | 2014-05-22 |
| 1619387131 | Sheri Slaughter | Counselor | 102 N. Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1336559848 | Heather Marlatt | Counselor | 102 North Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1811231939 | Wanda Luann Beesley Gray | Emergency Medical Technician, Paramedic | 3100 E St Hwy 78, Tishomingo, OK 73460 | 2012-11-15 |
| 1497014724 | Jessica Kay Johnston | Counselor | Outpatient Services-tishomingo; 817 E. 6th St., Strong Family Development, Tishomingo, OK 73460 | 2012-05-07 |
| 1487910949 | Rhonda Gayle Harrison | Counselor | 817 E. 6th St., Medical Family Therapy, Tishomingo, OK 73460 | 2012-04-09 |
| 1265704183 | Parks Family Dental | Preferred Provider Organization | 1520 E. Main Street, Tishomingo, OK 73460 | 2012-02-08 |
| 1770852295 | Gina Marice Frazier | Social Worker | Outpatient Services- Tishomingo, 817 E. 6th St., Tishomingo, OK 73460 | 2011-12-29 |
| Find all providers in zip 73460 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1811405202 | Integris Prohealth Inc | Pharmacy | 7301 Sw 44th St # F, Oklahoma City, OK 73179-4308 | 2018-01-19 |
| 1770908675 | Creoks Mental Health Services, Inc., Dba Truwellness Rx | Pharmacy | 105 East Ross Avenue, Sapulpa, OK 74066-6423 | 2014-02-28 |
| 1629419726 | Open Arms Clinic | Pharmacy | 5252 N Meridian Ave Ste 101, Oklahoma City, OK 73112-2136 | 2013-07-17 |
| 1699804708 | Great Plains Regional Medical Center | Pharmacy | 825 Sooner Dr., Burns Flat, OK 73624 | 2007-03-05 |
| 1639234057 | Allen Pharmacy Inc | Pharmacy | 521 E Franklin Ave, Weatherford, OK 73096-5337 | 2006-12-26 |
| 1902918915 | Oklahoma County Clinic Phcy | Pharmacy | 7401 Ne 23rd St, Oklahoma City, OK 73141-1420 | 2006-08-31 |
| 1730539487 | Good Shepherd Community Clinic, Inc | Pharmacy | 20 12th Ave Nw, Ardmore, OK 73401-5722 | 2016-06-14 |
| 1700268844 | Community Health Connection, Inc. | Pharmacy | 2321 E 3rd St, Tulsa, OK 74104-1831 | 2015-06-25 |
| 1124382585 | Rx Concepts LLC | Pharmacy | 7302 S Yale Ave Ste 101, Tulsa, OK 74136-7027 | 2012-07-01 |
| 1407116668 | Creek Nation Hospital & Clinics | Pharmacy | 325 S Washita St, Wetumka, OK 74883-5522 | 2012-05-22 |
| Find all providers with the same taxonomy | ||||
| City | TISHOMINGO |
| Zip Code | 73460 |
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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.