CHOCTAW NATION OF OKLAHOMA (NPI# 1851448526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851448526 |
Entity Type | Organization |
Organization Name | CHOCTAW NATION OF OKLAHOMA |
Other Organization Name | CHOCTAW NATION RUBIN WHITE POTEAU CLINIC PHARMACY |
Practice Address |
109 Kerr Ave Poteau OK 74953-5270 |
Practice Telephone | 9185677096 |
Practice Fax Number | 9185677041 |
Mailing Telephone | 9185677096 |
Mailing Fax Number | 9185677041 |
Enumeration Date | 2007-01-04 |
Last Update Date | 2013-05-07 |
Authorized Official Name | MRS. TERESA K JACKSON (ADMINISTRATOR) |
Authorized Official Telephone | 9185677000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261Q00000X | Clinic/Center | 19-3887 | OK | Ambulatory Health Care Facilities |
Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 19-5161 | OK | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | 100244980B | 05 |
Other Name | Type Code |
---|---|
Choctaw Nation Rubin White Poteau Clinic 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 |
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 |
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 |
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 |
109 KERR AVE |
City | POTEAU |
State | OK |
Zip Code | 74953-5270 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134105059 | Frank Jay Smith | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2005-12-22 |
1134690944 | Crystal D Hensley | Registered Nurse | 109 Kerr Ave, Poteau, OK 74953-5270 | 2018-12-06 |
1174004139 | Alex Nevitt | Physical Therapist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2018-08-27 |
1780136705 | Choctaw Nation Health Services Authority | Clinic/Center | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-10-25 |
1316493380 | Megan Schmidt | Pharmacist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-08-30 |
1669838983 | Michelle Rene Dawson | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-01-04 |
1578938064 | Jammie Owens | Pharmacist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2015-12-09 |
1457734063 | Jennifer Dillard | Optometrist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2015-06-30 |
1063847556 | Stefanie Janine Terrell | Pharmacist | 109 Kerr Ave, Poteau, OK 74953 | 2013-09-04 |
1841549318 | Jessica Lois Hall | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2012-08-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235644550 | Kim Lynn Mcconnell | Case Manager/Care Coordinator | 907 Grace St., Poteau, OK 74953 | 2017-12-08 |
1356889745 | Brenda Stacy | Prevention Professional | 507 Drwey, Potesu, OK 74953 | 2017-02-06 |
1639621451 | Sabrina Danielle Minor | Case Manager/Care Coordinator | 15715 Greentop Road, Poteau, OK 74953 | 2016-10-27 |
1902352545 | Daniel Jesse Bruesch | Counselor | 600 Oklahoma Ave., Poteau, OK 74953 | 2016-09-01 |
1578912465 | Jo Ann Walden | Counselor | 507 Dewey Avenue, Poteau, OK 74953 | 2016-06-10 |
1154708477 | Kendal Repass | Specialist/Technologist | 17100 Nail Creek, Poteau, OK 74953 | 2015-05-06 |
1669891768 | Jennifer Branscum | Case Manager/Care Coordinator | 22681 Valley View Rd, Poteau, OK 74953 | 2014-04-16 |
1437582145 | Kim Loggains | Counselor | 2104 A-n. Broadway, Poteau, OK 74953 | 2013-08-16 |
1457783573 | Derek Morris | Counselor | 3111b N. Broadway St., Box 34, Poteau, OK 74953 | 2013-07-31 |
1568743177 | Carol Ann Oliver | Counselor | 34183 Country Club Lane, Poteau, OK 74953 | 2011-09-09 |
Find all providers in zip 74953 |
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 |
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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.