SAC & FOX NATION (NPI# 1366455420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366455420 |
| Entity Type | Organization |
| Organization Name | SAC & FOX NATION |
| Other Organization Name | BLACK HAWK HEALTH CENTER |
| Practice Address |
Rr 2 Box 247 Stroud OK 74079-9652 |
| Practice Telephone | 9189689531 |
| Practice Fax Number | 9189680113 |
| Mailing Telephone | 9189689531 |
| Mailing Fax Number | 9189680113 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2008-06-12 |
| Authorized Official Name | MS. JANE RICH (PHARMACY MANAGER) |
| Authorized Official Telephone | 9189689531 |
| 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 | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100729660C | 05 | |
| OK | NCPDP | 3723269 | 01 |
| Other Name | Type Code |
|---|---|
| BLACK HAWK HEALTH CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1083821011 | Sac & Fox Nation | Clinic/Center | Rr 2 Box 247, Stroud, OK 74079-9652 | 2007-05-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SAC & FOX NATION | 920883 S Hwy 99 Bldg A, Stroud, OK 74079-5178 |
| Street Address |
RR 2 BOX 247 |
| City | STROUD |
| State | OK |
| Zip Code | 74079-9652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134114903 | Glenn Rusty Rex | Pharmacist | Rr 2 Box 247, Stroud, OK 74079-9652 | 2005-09-16 |
| 1083821011 | Sac & Fox Nation | Clinic/Center | Rr 2 Box 247, Stroud, OK 74079-9652 | 2007-05-17 |
| 1780742924 | Debra Kay Mee | Psychiatry & Neurology | Rr 2 Box 247, Stroud, OK 74079-9652 | 2006-12-04 |
| 1235219783 | Amanda Harkreader | Pharmacist | Rr 2 Box 247, Stroud, OK 74079-9652 | 2006-10-17 |
| 1407869548 | Jane Rich | Pharmacist | Rr 2 Box 247, Stroud, OK 74079-9652 | 2006-08-13 |
| 1912929324 | Tom E Denton | Family Medicine | Rr 2 Box 247, Stroud, OK 74079-9652 | 2006-07-24 |
| 1275510349 | Eugene M Hoyt | Internal Medicine | Rr 2 Box 247, Stroud, OK 74079-9652 | 2005-12-29 |
| 1225024821 | Stacie Marie Miller | Pharmacist | Rr 2 Box 247, Stroud, OK 74079-9652 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649710369 | Daniel Hall | Nurse Practitioner | 2308 Ok-66, Stroud, OK 74079 | 2017-02-28 |
| 1407106636 | Danita Kollars | Counselor | 256110 E. 930 Rd, Stroud, OK 74079 | 2012-09-14 |
| 1790798411 | Dental Designs of Stroud | Dentist | 401 W Main, Stroud, OK 74079 | 2006-08-14 |
| 1720019953 | Fidelity Health Care Consultants, P.C. | Clinic/Center | 320 North 4th Ave., Stroud, OK 74079 | 2006-07-05 |
| 1205836061 | Thomas Seymour Henry | Internal Medicine | Route 2 Box 247, Black Hawk Health Center, Stroud, OK 74079 | 2005-07-22 |
| 1275934283 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1600 W Highway 66, Stroud, OK 74079-2804 | 2014-09-09 |
| 1548603855 | Jennifer Dae Arvizu | Occupational Therapy Assistant | 218 W 5th St, Stroud, OK 74079-3419 | 2013-04-17 |
| 1073030243 | John Daniel Neal | Counselor | 501 N 1st Ave, Stroud, OK 74079-3446 | 2017-08-28 |
| 1508999145 | Timothy D Moore Od PC | Optometrist | 109 W Main St, Stroud, OK 74079-3607 | 2007-03-13 |
| 1417935008 | Timothy Dean Moore | Optometrist | 109 W Main St, Stroud, OK 74079-3607 | 2006-01-04 |
| Find all providers in zip 74079 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 1295142115 | Choctaw Nation of Oklahoma | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1801 Chukka Hina, Durant, OK 74701 | 2014-07-14 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.