NPIMap

Organization Active NPI

Creek Nation Hospital & Clinics

Doing business as Koweta Indian Health Facility

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Coweta, OK
National Provider Identifier
1518059674
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
License
385091 Issued in OK
Legal business name
CREEK NATION HOSPITAL & CLINICS
Doing business as
Koweta Indian Health Facility
Practice address
31870 East Hwy 51
Coweta, OK 74429
Phone
(918) 279-3200
Fax
(918) 756-2464
NPI assigned
Sep 28, 2006
Last updated
Dec 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MUSCOGEE (CREEK) NATION DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shawn Terry, PHARMD
Title
Secretary of Health
Phone
(918) 756-9909

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X 385091 OK Primary
Clinic Pharmacy 3336C0002X NU
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

31870 East Hwy 51
Coweta, OK 74429

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2077066OtherPK
100809770NMedicaidOK

Other names 1

  • KOWETA INDIAN HEALTH FACILITY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231030000538 OK DME Supplier - Indian Health Service Or Tribal FacilityDME Supplier - Pharmacy 5698786226 Practice locations: Coweta, OK

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2083580Koweta Indian Health Facility Pharmacy31870 E Hwy 51, Coweta, OK 74429Certificate of waiverSep 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
Creek Nation Hospital Clinics84 organizations share this tax ID, including this one
Part of
Creek Nation Hospital Clinics

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

Mcn Pharmacy
Dept 1249
Tulsa, OK 74182

Ownership & related parties

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1518059674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MCN PHARMACY",
            "address_2": "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": "31870 EAST HWY 51",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "74429",
            "telephone_number": "918-279-3200",
            "fax_number": "918-756-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK NATION HOSPITAL & CLINICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUSCOGEE (CREEK) NATION DEPARTMENT OF HEALTH",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "SECRETARY OF HEALTH",
        "authorized_official_telephone_number": "918-756-9909",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "OK",
            "license": "385091",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077066",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100809770N",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KOWETA INDIAN HEALTH FACILITY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KOWETA INDIAN HEALTH FACILITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coweta, OK

Sources for this page

Verify at the official NPI Registry.