STATE OF OKLAHOMA (NPI# 1902063902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902063902 |
| Entity Type | Organization |
| Organization Name | STATE OF OKLAHOMA |
| Other Organization Name | LAWTON VETERANS CENTER |
| Practice Address |
501 Se Flower Mound Rd Lawton OK 73501-6388 |
| Practice Telephone | 5803516511 |
| Practice Fax Number | 5803516511 |
| Mailing Telephone | 5803516511 |
| Mailing Fax Number | 5803516511 |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | TINA WILLIAMS (COMPLIANCE DIRECTOR) |
| Authorized Official Telephone | 4055234000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
3-4725 | OK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2176125 | 01 |
| Other Name | Type Code |
|---|---|
| Lawton Veterans Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225352057 | State of Oklahoma | Community/Behavioral Health | 400 North Oak, Taft, OK 74463 | 2010-03-23 |
| 1790922185 | State of Oklahoma | Community Based Residential Treatment Facility, Mental Illness | 2323 South Harvard, Tulsa, OK 74114 | 2009-01-07 |
| 1124286059 | State of Oklahoma | Pharmacy | 304 Fairlane Ave, Sulphur, OK 73086-6861 | 2008-05-28 |
| 1154589430 | State of Oklahoma | Skilled Nursing Facility | 10014 Se 1138th Street, Talihina, OK 74571-6028 | 2008-05-23 |
| 1225295710 | State of Oklahoma | Skilled Nursing Facility | 1701 South 4th, Clinton, OK 73601-1209 | 2008-05-21 |
| 1881872182 | State of Oklahoma | Skilled Nursing Facility | 900 E. Airport Rd., Okmulgee, OK 74447 | 2008-02-08 |
| 1720152788 | State of Oklahoma | Community/Behavioral Health | 702 N. Grand, Northwest Center for Behavioral Health, Enid, OK 73701 | 2006-11-20 |
| 1750456588 | State of Oklahoma | Community/Behavioral Health | 1222 10th Street, Suite 211, Northwest Center for Behavioral Health, Woodward, OK 73801-3156 | 2006-11-20 |
| 1700950201 | State of Oklahoma | Substance Abuse Rehabilitation Facility | 5050 Williams Avenue, Northwest Center for Behavioral Health, Woodward, OK 73801 | 2006-11-17 |
| 1922171701 | State of Oklahoma | Psychiatric Hospital | 1 Mile East U.S. Highway 270, Fort Supply, OK 73841-0001 | 2006-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STATE OF OKLAHOMA EAST CENTRAL UNIVERSITY | 1100 E 14th St, Ada, OK 74820-6999 |
| Street Address |
501 SE FLOWER MOUND RD |
| City | LAWTON |
| State | OK |
| Zip Code | 73501-6388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295955151 | Valarie Jean Eck | Pharmacist | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2007-04-25 |
| 1780298141 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2020-09-03 |
| 1174148191 | Anna Louise Barkman | Occupational Therapist | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2020-06-15 |
| 1528694270 | Jeremy Joseph Swanson | Physical Therapy Assistant | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2020-03-13 |
| 1346874476 | Brian Jason Hilliary | Physical Therapy Assistant | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2020-02-27 |
| 1942848205 | Briana Theresa Mcintyre | Occupational Therapy Assistant | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2019-12-18 |
| 1316411036 | Heather Marie Dougherty | Occupational Therapist | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2019-01-15 |
| 1114490513 | Stephanie Little | Speech-Language Pathologist | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2019-01-08 |
| 1285106336 | Elizabeth Ann Bluebird | Physical Therapist | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2018-12-28 |
| 1649745787 | Simone Guthrie | Nurse Practitioner | 501 Se Flower Mound Rd, Lawton, OK 73501-6388 | 2018-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596729 | Alyssa K Manfredi | Speech-Language Pathologist | 1700 Nw Lee Blvd, Lawton, OK 73501 | 2020-10-21 |
| 1295079705 | Premier Behavorial Health | Community/Behavioral Health | 2305 Southwest H Avenue, Suite #1, Lawton, OK 73501 | 2012-11-21 |
| 1306156989 | Diana Nix | Licensed Practical Nurse | 611 Sw B Ave, Lawton, OK 73501 | 2010-10-15 |
| 1689993214 | Crystal Leday | Physical Therapy Assistant | 602 S.e. Wallock, Lawton, OK 73501 | 2010-05-21 |
| 1457679862 | Gary Dean Gardner | Dentist | 1301 West Gore Blvd, Suite 2, Lawton, OK 73501 | 2010-05-10 |
| 1962729848 | Tayler Gammon | Hearing Instrument Specialist | 423 S.w. C Ave, Lawton, OK 73501 | 2010-04-30 |
| 1932430725 | Eric B Carpenter Sr. | Counselor | 807 Sw F Avenue, Lawton, OK 73501 | 2010-01-19 |
| 1447487640 | Benjamin Llanos | Counselor | 1719 Sw 11th, Lawton, OK 73501 | 2009-06-15 |
| 1710122833 | Provide Hearing Aids | Public Health or Welfare | 1201 West Gore Blvd, Suite D, Lawton, OK 73501 | 2008-12-03 |
| 1053506121 | Mercer Beauty Supply | Orthotic Fitter | 1016 Sw D Ave, Lawton, OK 73501 | 2007-09-11 |
| Find all providers in zip 73501 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1730230665 | Kens Rx Discount Pharmacy | Pharmacy | 802 W Gore Blvd, Lawton, OK 73501-3719 | 2007-01-16 |
| 1215958285 | Eastside Clinic Pharmacy | Pharmacy | 3612 Se Lee Blvd, Lawton, OK 73501-8451 | 2006-07-22 |
| 1437157559 | Merich Corporation | Pharmacy | 7210 Nw Cache Rd, Lawton, OK 73505-2712 | 2005-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208817 | Op Pharmacy LLC | Pharmacy | 2865 E. Skelly Dr., Ste 225, Tulsa, OK 74105 | 2020-09-08 |
| 1932725058 | Economy Pharmacy | Pharmacy | 10120 E 91st, Tulsa, OK 74133 | 2020-06-24 |
| 1508486978 | Economy Pharmacy | Pharmacy | 3414 W. Okmulgee, Muskogee, OK 74401 | 2020-04-25 |
| 1396381679 | Apothecary Associates LLC | Pharmacy | 1315 N Washington St Ste 3, Weatherford, OK 73096-2443 | 2019-11-21 |
| 1093271769 | Veritas Properties LLC | Pharmacy | 225 W Main St Ste 1, Wilburton, OK 74578-4045 | 2019-02-18 |
| 1649747841 | Pharmacorr, LLC | Pharmacy | 7400 Plaza Mayor Blvd, Ste 100, Oklahoma City, OK 73149 | 2018-10-26 |
| 1467996223 | R&s Drug Store 2 LLC | Pharmacy | 821 W Main St # 201, Duncan, OK 73533-4615 | 2016-12-13 |
| 1982147468 | Hobbs Pharmacy Inc | Pharmacy | 420 W Broadway Ave, Sulphur, OK 73086-4622 | 2016-12-01 |
| 1194185504 | Guardian Pharmacy of Tulsa, LLC | Pharmacy | 5415 S 125th East Ave, Suite 201-203, Tulsa, OK 74146-6232 | 2016-02-26 |
| 1558749192 | Texoma Medical Services Inc | Pharmacy | 417 Sw 7th St Ste 2, Mooreland, OK 73852-7603 | 2015-05-15 |
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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.