The Chickasaw Nation Employee Clinic Pharmacy- Ada

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

THE CHICKASAW NATION EMPLOYEE CLINIC PHARMACY- ADA

Doing business as

Chickasaw Nation Employee Clinic Pharmacy
Chickasaw Nation Employee Clinic Pharmacy- Norman
Chickasaw Nation Employee Clinic Pharmacy-Ada

Practice address

1007 N Country Club Rd
Ada, OK 74820-2847

Phone

(580) 421-8775

Fax

(580) 421-8789

NPI assigned

Jun 15, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Duane Sellers, DPH

Title

Director of Tribal Pharmacy Service

Phone

(580) 235-6419

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 3

• Chickasaw Nation Employee Clinic Pharmacy Doing business as
• Chickasaw Nation Employee Clinic Pharmacy- Norman Doing business as
• Chickasaw Nation Employee Clinic Pharmacy-Ada Doing business as

Locations

Practitioners 3

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

• Amanda V Conley, PHARMD

  • Pharmacist
  • Sulphur, OK
  • NPI 1083221063
  NPD
• Matthew Fleming, PHARMD

  • Pharmacist
  • Norman, OK
  • NPI 1871050831
  NPD
• Gina Danielle Garrett, DPH

  • Pharmacist
  • Ada, OK
  • NPI 1689261315
  NPD

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1710249628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 N COUNTRY CLUB RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202847",
            "telephone_number": "580-421-8775",
            "fax_number": "580-421-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N COUNTRY CLUB RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202847",
            "telephone_number": "580-421-8775",
            "fax_number": "580-421-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHICKASAW NATION EMPLOYEE CLINIC PHARMACY- ADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "DIRECTOR OF TRIBAL PHARMACY SERVICE",
        "authorized_official_telephone_number": "580-235-6419",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "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": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200436850A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2135608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chickasaw Nation Employee Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chickasaw Nation Employee Clinic Pharmacy- Norman",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chickasaw Nation Employee Clinic Pharmacy-Ada",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Travis L Teel, PA
• Mellissa Betty Telena
• Chelsey Taylor Temple
• William Terral, DDS
• Samikshya Thapa, RD
• The Performance Center, PLLC
• Theea
• Theracomprx LLC
• Therapy in Motion of Oklahoma LLC
• Edward Kent Thomas, MD

• Community/Retail Pharmacy in Ada, OK
• Providers in Ada, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.