NPIMap

Organization Active NPI

Northwest Center for Behavioral Health

  • Institutional Pharmacy
  • Fort Supply, OK
National Provider Identifier
1710174107
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
44-2593 Issued in OK
Legal business name
NORTHWEST CENTER FOR BEHAVIORAL HEALTH
Doing business as
Northwest Center for Behavioral Health
Practice address
193461 E CT Rd 304
Fort Supply, OK 73841-0001
Phone
(580) 766-2311
Fax
(580) 766-2316
NPI assigned
Sep 28, 2007
Last updated
Dec 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Authorized official

Name
Christen Schmidt, DPH
Title
Director of Pharmacy
Phone
(580) 766-2311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 44-2593 OK Primary

Addresses

Primary practice location

193461 E CT Rd 304
Fort Supply, OK 73841-0001

Mailing address

PO Box 1
Fort Supply, OK 73841-0001

Other identifiers 3

IdentifierTypeStateIssuer
100704080AMedicaidOK
100704080BMedicaidOK
2074624OtherPK

Other names 1

  • NORTHWEST CENTER FOR BEHAVIORAL HEALTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carl Albert Community M140 organizations share this tax ID, including this one

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1710174107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "FORT SUPPLY",
            "state": "OK",
            "postal_code": "738410001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193461 E CT RD 304",
            "city": "FORT SUPPLY",
            "state": "OK",
            "postal_code": "738410001",
            "telephone_number": "580-766-2311",
            "fax_number": "580-766-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CENTER FOR BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "CHRISTEN",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "580-766-2311",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "OK",
            "license": "44-2593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100704080A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100704080B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074624",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHWEST CENTER FOR BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NORTHWEST CENTER FOR BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Supply, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.