Chickasaw Nation Division of Health

Primary specialty

Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X

License

23-5511 Issued in OK

Legal business name

CHICKASAW NATION DIVISION OF HEALTH

Practice address

1904 Carl Albert Blvd Ste a
Ada, OK 74820-3493

Phone

(580) 272-5710

Fax

(580) 272-5711

NPI assigned

Mar 10, 2010

Organization subpart

No

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

Authorized official

Name

Zach Williams

Title

Pharmacist

Phone

(580) 436-3980

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Chickasaw Nation Medical Center Outpatient Pharmacy Doing business as

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Scott Charlton, PHARM. D.

  • Ambulatory Care Pharmacist
  • Ada, OK
  • NPI 1316827298
  NPD
• Jonathan Keith Willett, PHARMD

  • Pharmacist
  • Ada, OK
  • NPI 1154928166
  NPD

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1649593252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER DR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-436-3980",
            "fax_number": "580-421-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 CARL ALBERT BLVD STE A",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203493",
            "telephone_number": "580-272-5710",
            "fax_number": "580-272-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICKASAW NATION DIVISION OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ZACH",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "580-436-3980"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "OK",
            "license": "23-5511",
            "primary": true
        },
        {
            "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124048",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "23-8479",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chickasaw Nation Medical Center Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center
• 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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.