NPIMap

Organization Active NPI

Creek Nation Hospital & Clinics

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Tulsa, OK
National Provider Identifier
1265004667
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
CREEK NATION HOSPITAL & CLINICS
Practice address
10109 E 79TH St
Outpatient Pharmacy
Tulsa, OK 74133
Phone
(855) 771-4321
Fax
(918) 756-2464
NPI assigned
Jul 14, 2021
Organization subpart
Yes
Parent organization
CREEK NATION HOSPITAL & CLINICSAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Dusty Allen
Title
Pharmacy Billing Manager
Phone
(918) 756-4233

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Practitioners 364

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231211003192 OK DME Supplier - Indian Health Service Or Tribal FacilityDME Supplier - Pharmacy 5698786226 Practice locations: Tulsa, OK

All facility ownership & control disclosures 1

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Creek Nation Community HospitalOkemah, OK, CCN 37Z333 Hospital Operational/Managerial Control Nov 1, 2007

National Provider Directory

National Provider Directory
Tax ID family
Creek Nation Hospital and Clinics (84 organizations share this tax ID)
Part of
Creek Nation Hospital and Clinics

Specialties & licenses 5

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Specialty Pharmacy 3336S0011X

Addresses

NPPES NPI Registry

Primary practice location

10109 E 79TH St
Outpatient Pharmacy
Tulsa, OK 74133

Mailing address

MCN Pharmacy Dept # 1249
Tulsa, OK 74182-0001
Phone (918) 756-9909

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
100699980KMedicaidOK

Other names 1

NPPES NPI Registry
  • Council Oak Comprehensive Health Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 13, 2024.

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1265004667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MCN PHARMACY DEPT # 1249",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741820001",
            "telephone_number": "918-756-9909",
            "fax_number": "918-756-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10109 E 79TH ST",
            "address_2": "OUTPATIENT PHARMACY",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74133",
            "telephone_number": "855-771-4321",
            "fax_number": "918-756-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK NATION HOSPITAL & CLINICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CREEK NATION HOSPITAL & CLINICS",
        "enumeration_date": "2021-07-14",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "DUSTY",
        "authorized_official_title_or_position": "PHARMACY BILLING MANAGER",
        "authorized_official_telephone_number": "918-756-4233"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699980K",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Council Oak Comprehensive Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Council Oak Comprehensive Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.