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THACKERVILLE PHARMACY
NPI 1669777058
Pharmacy - Community/Retail Pharmacy in Thackerville, OK

Active since January 18, 2011
11530 RIDGE RD STE 1, THACKERVILLE, OK 73459(580) 276-5161(580) 276-9063 Get Directions Write a Review

NPPES record last updated: March 6, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Thackerville Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THACKERVILLE PHARMACY (NPI 1669777058) is a healthcare organization registered as a community/retail pharmacy in Thackerville, Oklahoma and active in the NPI registry since January 2011. The organization lists Susan South, Manager, as its authorized official.

NPPES Registry Identity

NPI1669777058
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameTHACKERVILLE PHARMACY
Location Address11530 RIDGE RD STE 1Thackerville, OK 73459-9623
Mailing Address11530 Ridge Rd, Suite 1Thackerville, OK 73459-9622 · (580) 276-5161 · Fax (580) 276-9063
Phone(580) 276-5161
Fax(580) 276-9063
Organization SubpartNo
Authorized OfficialSusan SouthManager · (580) 276-5161
Enumeration DateJanuary 18, 2011
Last NPPES UpdateMarch 6, 2017
✔ NPI 1669777058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in OK · 72-5917
Definition
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.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
11530 RIDGE RD STE 1, Thackerville, OK 73459
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Other Names 1

Doing Business AsThackerville Pharmacy

Other Identifiers 3

Medicaid580121TX
Other2129291Pk
Medicaid200339440AOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RED RIVER VALLEY HEALTH PLLC
Nurse Practitioner (Family)
11530 RIDGE RD STE 1
THACKERVILLE, OK 73459
Love County (580) 276-9066
THACKERVILLE MEDICAL CLINIC
Nurse Practitioner (Family)
11530 RIDGE RD STE 1
THACKERVILLE, OK 73459
Love County (580) 276-9066

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thackerville Pharmacy's NPI number?

The NPI number for Thackerville Pharmacy is 1669777058. It was assigned to this organization in the NPPES registry on January 18, 2011.

Where is Thackerville Pharmacy located?

Thackerville Pharmacy is located at 11530 Ridge Rd Ste 1, Thackerville, OK 73459. The listed phone number is (580) 276-5161.

What is Thackerville Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

What insurance does Thackerville Pharmacy accept?

Health plans from Medica and Moda Health Plan, Inc. list Thackerville Pharmacy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thackerville Pharmacy was last updated on March 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.