CHICKASAW NATION DIVISION OF HEALTH (NPI# 1750406757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750406757 |
| Entity Type | Organization |
| Organization Name | CHICKASAW NATION DIVISION OF HEALTH |
| Other Organization Name | TISHOMINGO INDIAN CLINIC PHARMACY |
| Practice Address |
817 E 6th St Tishomingo OK 73460-1800 |
| Mailing Address |
1921 Stonecipher Dr Ada OK 74820-3439 |
| Practice Telephone | 5803712392 |
| Practice Fax Number | 5804214552 |
| Mailing Telephone | 5804214597 |
| Mailing Fax Number | 5804214598 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2015-02-10 |
| Authorized Official Name | ZACH WILLIAMS (PHARMACIST) |
| Authorized Official Telephone | 5802722710 |
| Authorized Official Credential | DPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 61-6174 | OK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2074771 | 01 | |
| OK | 100244600B | 05 |
| Other Name | Type Code |
|---|---|
| TISHOMINGO INDIAN CLINIC PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295399095 | Chickasaw Nation Division of Health | Durable Medical Equipment & Medical Supplies | 1904 Carl Albert Blvd Ste B, Ada, OK 74820-3493 | 2019-04-26 |
| 1487715587 | Chickasaw Nation Division of Health | Pharmacy | 933 N Country Club Rd, Ada, OK 74820-2845 | 2006-12-12 |
| 1376652180 | Chickasaw Nation Division of Health | Technician/Technologist | 1005 N Country Club Rd, Ada, OK 74820-2847 | 2006-08-29 |
| 1174063903 | Chickasaw Nation Division of Health | Medicare Defined Swing Bed Unit | 1921 Stonecipher Blvd, Ada, OK 74820-3439 | 2017-02-27 |
| 1649593252 | Chickasaw Nation Division of Health | Pharmacy | 1921 Stonecipher Dr, Ada, OK 74820-3439 | 2010-03-10 |
| 1598943706 | Chickasaw Nation Division of Health | Clinic/Center | 1921 Stonecipher Blvd, Ada, OK 74820-3439 | 2008-02-11 |
| 1669597027 | Chickasaw Nation Division of Health | Pharmacy | 2510 Chickasaw Blvd, Ardmore, OK 73401-1341 | 2007-03-21 |
| 1215052675 | Chickasaw Nation Division of Health | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1007 N Country Club Rd, Ada, OK 74820-2847 | 2007-03-21 |
| 1396860003 | Chickasaw Nation Division of Health | Pharmacy | 1438 Hardcastle Blvd, Purcell, OK 73080-8233 | 2007-03-20 |
| Street Address |
817 E 6TH ST |
| City | TISHOMINGO |
| State | OK |
| Zip Code | 73460-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801879838 | Michael J Reyes | Physician Assistant | 817 E 6th St, Tishomingo, OK 73460-1800 | 2005-11-23 |
| 1710545934 | Chelsea Griffin | Case Manager/Care Coordinator | 817 E 6th St, Tishomingo, OK 73460-1800 | 2019-06-03 |
| 1366983249 | Shawnna Smith | Registered Nurse | 817 E 6th St, Tishomingo, OK 73460 | 2017-03-13 |
| 1710428693 | Jennifer Corbin | Registered Nurse | 817 E 6th St, Tishomingo, OK 73460 | 2017-03-13 |
| 1003364787 | Brianna Megan Thompson | Counselor | 817 E 6th St, Tishomingo, OK 73460-1800 | 2016-09-12 |
| 1730530932 | Tammy Holder | Nurse Practitioner | 817 E 6th St, Tishomingo, OK 73460-1800 | 2016-06-29 |
| 1184028540 | Courtney Alisha Airington | Nurse Practitioner | 817 E 6th St, Tishomingo, OK 73460-1800 | 2014-10-14 |
| 1487918553 | Clayton Andrew Garrett | Family Medicine | 817 E 6th St, Tishomingo, OK 73460 | 2012-07-03 |
| 1962546150 | Kenneth Leslie Cone | Dentist | 817 E 6th St, Tishomingo, OK 73460 | 2007-02-19 |
| 1649330242 | Chickasaw Nation Division of Health Chickasaw Nation Medical Center | Clinic/Center | 817 E 6th St, Tishomingo, OK 73460-1800 | 2006-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912380742 | Lori Pigg | Speech-Language Pathologist | 508 N. Neshoba, Tishomingo, OK 73460 | 2015-06-29 |
| 1407241748 | Brittany Walker | Case Management | 850 E. Highway 22, Tishomingo, OK 73460 | 2015-04-03 |
| 1427460641 | Elizabeth Mcdonald | Counselor | 512 East 24th, Tishomingo, OK 73460 | 2014-05-22 |
| 1619387131 | Sheri Slaughter | Counselor | 102 N. Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1336559848 | Heather Marlatt | Counselor | 102 North Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1811231939 | Wanda Luann Beesley Gray | Emergency Medical Technician, Paramedic | 3100 E St Hwy 78, Tishomingo, OK 73460 | 2012-11-15 |
| 1497014724 | Jessica Kay Johnston | Counselor | Outpatient Services-tishomingo; 817 E. 6th St., Strong Family Development, Tishomingo, OK 73460 | 2012-05-07 |
| 1487910949 | Rhonda Gayle Harrison | Counselor | 817 E. 6th St., Medical Family Therapy, Tishomingo, OK 73460 | 2012-04-09 |
| 1265704183 | Parks Family Dental | Preferred Provider Organization | 1520 E. Main Street, Tishomingo, OK 73460 | 2012-02-08 |
| 1770852295 | Gina Marice Frazier | Social Worker | Outpatient Services- Tishomingo, 817 E. 6th St., Tishomingo, OK 73460 | 2011-12-29 |
| Find all providers in zip 73460 | ||||
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | TISHOMINGO |
| Zip Code | 73460 |
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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.