Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1699357871 Deactivated / Inactive NPI Male Practitioner

Samuel Adam Davis , DPH

Pharmacist • Broken Arrow, OK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Samuel Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 27, 2021
NPI Deactivation Date July 26, 2022
Total Practice Duration ~1 Years of Practice (2021 – 2022)

Professional Overview & Biography Verified Profile Summary

Samuel Davis, DPH was a registered Pharmacist practicing in Broken Arrow, OK. Throughout an active medical career spanning 1 years, Samuel Davis provided care at the practice location at 6310 S ELM PL until profile deactivation on 2022-07-26.

Practice Location & Contact Primary Location

Practice Address

6310 S Elm Pl

Broken Arrow, OK 740114100

Telephone 9184554386
Associated Practice Facility / Clinic
🏢 Wal-Mart Stores East Lp Facility NPI 1235156373

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Broken Arrow, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
111 Specialists

Practicing in Broken Arrow, OK (3455 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License OK 7099

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Tami Eberle

Pharmacist

NPI 1124629191
NPI 1144823337

Doctor of Pharmacy (Pharm.D.)

NPI 1427650324
Grant Martin

Pharmacist

NPI 1578491031
NPI 1659655140

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 26, 2022

Record deactivated on July 26, 2022

NPI Profile Active April 27, 2021

NPI status registered as active in NPPES database

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Updated Practice Location April 27, 2021

Registered at 6310 S ELM PL, BROKEN ARROW, OK 740114100 (Tel: 9184554386)

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Updated Business Mailing Address April 27, 2021

Registered at 1414 SHERWOOD LN, BROKEN ARROW, OK 740118232 (Tel: 9184498777)

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Provider Name / Credentials Updated April 27, 2021

Recorded as SAMUEL DAVIS, DPH

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 27, 2021

Pharmacist (License #7099 in OK)

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Initial NPI Registration & Enumeration April 27, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1699357871
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 27, 2021
Last Update: April 27, 2021
Deactivation Date: July 26, 2022

Mailing Address

1414 Sherwood Ln

Broken Arrow, OK 740118232

Phone: 9184498777

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.