Chickasaw Nation Division of Health
Organization Active NPI Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Ada, OK
NPI 1487715587 · NPPES record last updated Mar 9, 2016
Key facts
- NPI
- 1487715587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
- License
- 235613 (OK)
- Legal business name
- CHICKASAW NATION DIVISION OF HEALTH
- Practice address
- 933 N Country Club Rd
Ada, OK 74820-2845 - Phone
- (580) 272-5710
- Fax
- (580) 272-5711
- NPI assigned
- Dec 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Zach Williams, RPH
- Title
- Pharmacist
- Phone
- (580) 272-5710
Owned or controlled facilities with NPI records 6
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 12
Practitioners 243
-
Thomas Samuel Ahrend, D.O.
-
Nicole Jeanne Alvarez, CRNA
-
Aerial A Avery, D.P.M
-
Ramona Juanita Baker, APRN
-
Lucretia Renee Barker, M.D.
-
Coty Barlow, APRN, CNP
-
Jeffery David Barlow, DNP, APRN
-
Michelle Baxter, APRN, FNP-C
-
Rachel Lee Bell, LPC
-
Kendall Bellefeuille, LPC CANDIDATE
-
Laura Eve Brewer-James, APRN
-
Shawn Bridwell, PA
-
Danielle Renee Burkdoll, D.O.
-
Laura Coleen Byous-Schaefer, APRN-CNM
-
Karen Sue Carr, M.A., LPC
-
Roger John Charboneau, D.O.
-
Candis Clark, OD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Chickasaw Nation Refill Center |
Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order) | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Chickasaw Nation Medical Center |
Hospital | Operational/Managerial Control | Oct 1, 1994 |
| Minticha Apila |
Home health agency | Operational/Managerial Control (100%) | Oct 1, 1994 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180323000394 | OK | DME Supplier - Indian Health Service Or Tribal Facility | 8426957523 | Practice locations: Ada, OK |
National Provider Directory
- Tax ID family
- CNHS Finance
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | 235613 | OK | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
933 N Country Club Rd
Ada, OK 74820-2845
Mailing address
933 N Country Club Rd
Ada, OK 74820-2845
Phone (580) 272-5710
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10024620A | Medicaid | OK | |
| 2076080 | Other | PK |
Other names
- Chickasaw Nation Refill Center
Other providers in Ada, OK
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health
- Chickasaw Nation Division of Health Chickasaw Nation Medical Center
All providers in Ada, OK · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.