CHOCTAW NATION OF OKLAHOMA (NPI# 1295142115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295142115 |
Entity Type | Organization |
Organization Name | CHOCTAW NATION OF OKLAHOMA |
Other Organization Name | CHOCTAWNATION HEALTH SYSTEM DURANT HEALTH CENTER PHARMACY |
Practice Address |
1801 Chukka Hina Durant OK 74701 |
Mailing Address |
One Choctaw Way Talihina OK 74571-2022 |
Practice Telephone | 5809202100 |
Practice Fax Number | 9185677180 |
Mailing Telephone | 9185677000 |
Mailing Fax Number | 9185677041 |
Enumeration Date | 2014-07-14 |
Last Update Date | 2017-02-23 |
Authorized Official Name | MRS. TERESA K JACKSON (SENIOR EXECUTIVE OFFICER OF HEALTH) |
Authorized Official Telephone | 9185677000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 276867 | OK | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP | 3728334 | 01 | |
OK | STATE BOARD OF PHARMACY | 27-6867 | 01 |
PK | 2148099 | 01 | |
OK | STATE BOARD OF PHARMACY | 27-7805 | 01 |
Other Name | Type Code |
---|---|
ChoctawNation Health System Durant Health Center Pharmacy | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982992269 | Choctaw Nation of Oklahoma | Clinic/Center | 205 Dallas St, Talihina, OK 74571-2402 | 2011-07-20 |
1902078728 | Choctaw Nation of Oklahoma | Clinic/Center | 1201 W Liberty Rd, Atoka, OK 74525-1639 | 2008-04-01 |
1174599088 | Choctaw Nation of Oklahoma | Clinic/Center | 410 North M, Hugo, OK 74743 | 2006-02-28 |
1770559619 | Choctaw Nation of Oklahoma | Clinic/Center | 205 E 3rd St, Broken Bow, OK 74728-4119 | 2006-02-28 |
1104344027 | Choctaw Nation of Oklahoma | Clinic/Center | 1 Choctaw Way, Talihina, OK 74571-2022 | 2017-08-30 |
1306384821 | Choctaw Nation of Oklahoma | Clinic/Center | 1801 Chukka Hina, Durant, OK 74701-3085 | 2017-02-03 |
1396173449 | Choctaw Nation of Oklahoma | Clinic/Center | 1801 Chukka Hina, Durant, OK 74701-3085 | 2013-10-29 |
1659674455 | Choctaw Nation of Oklahoma | General Acute Care Hospital | 1 Choctaw Way, Talihina, OK 74571-2022 | 2010-12-16 |
1790833564 | Choctaw Nation of Oklahoma | Clinic/Center | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2007-01-08 |
1609924471 | Choctaw Nation of Oklahoma | Clinic/Center | 2204 E Main St, Stigler, OK 74462-2822 | 2007-01-08 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | CHOCTAW NATION OF OKLAHOMA | 1802 Chukka Hina, Durant, OK 74701-7117 |
Street Address |
1801 CHUKKA HINA |
City | DURANT |
State | OK |
Zip Code | 74701 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558574574 | Michael H Arredondo | Internal Medicine | 1801 Chukka Hina, Durant, OK 74701-7117 | 2007-05-07 |
1811544307 | Ashley Morgan | Dietitian, Registered | 1801 Chukka Hina, Durant, OK 74701-7117 | 2019-08-20 |
1265085013 | Garrison Smith Lorey Sr. | Pulmonary Function Technologist | 1801 Chukka Hina, Durant, OK 74701-7117 | 2019-07-22 |
1356810808 | Cynthia Bernice Williams | Registered Nurse | 1801 Chukka Hina, Durant, OK 74701-7117 | 2018-11-14 |
1003399940 | Haley Harrison | Nurse Practitioner | 1801 Chukka Hina, Durant, OK 74701-7117 | 2018-09-06 |
1871097741 | Bobby Don Priddy Jr. | Nurse Practitioner | 1801 Chukka Hina, Durant, OK 74701 | 2018-03-23 |
1053824359 | Darci Lynn Bowen | Nurse Practitioner | 1801 Chukka Hina, Durant, OK 74701 | 2017-11-08 |
1306384821 | Choctaw Nation of Oklahoma | Clinic/Center | 1801 Chukka Hina, Durant, OK 74701-3085 | 2017-02-03 |
1235587627 | Quinton Tieu | Family Medicine | 1801 Chukka Hina, Durant, OK 74701-7117 | 2016-05-26 |
1396173449 | Choctaw Nation of Oklahoma | Clinic/Center | 1801 Chukka Hina, Durant, OK 74701-3085 | 2013-10-29 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
Find all providers in zip 74701 |
Taxonomy Code | 332800000X |
Grouping | Suppliers |
Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |
Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639472970 | Carnegie Indian Health Clinic | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 212 E. 4th St, Carnegie, OK 73015 | 2010-12-08 |
1568512374 | Wewoka Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Intersection of Hwy 56 and 270, Wewoka, OK 74884 | 2007-01-12 |
1316097389 | Anadarko Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 115 Ne Old Town Rd, Anadarko, OK 73005-5009 | 2007-01-11 |
1538219431 | El Reno Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1801 Parkview Drive, El Reno, OK 73632 | 2007-01-11 |
1871663203 | Sac & Fox Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 356110 E 930 Rd, Stroud, OK 74079-5184 | 2006-11-09 |
1699790543 | Li-si-wi-nwi Health, Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 15951 Little Axe Drive, Norman, OK 73026-9001 | 2006-07-13 |
1952303190 | Pawhuska Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 715 Grandview Ave, Pawhuska, OK 74056-3201 | 2005-06-01 |
1568839470 | Osage Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 715 Grandview Ave, Pawhuska, OK 74056-3201 | 2015-08-26 |
1598053993 | Citizen Potawatomi Nation West Clinic | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2011-07-19 |
1891999157 | White Eagle Health Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 200 White Eagle Drive, Ponca City, OK 74601 | 2007-06-12 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.