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CHICKASAW NATION DIVISION OF HEALTH NPI 1750406757


NPI Information

NPI: 1750406757
Provider Name: CHICKASAW NATION DIVISION OF HEALTH

Doing Business As: TISHOMINGO INDIAN CLINIC PHARMACY

Classification: Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy - 332800000X
Entity Type: Organization

CLIA Number: 37D0888227

Address:
817 E 6TH ST
TISHOMINGO, OK
ZIP 73460
Phone: (580) 371-2392
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CHICKASAW NATION DIVISION OF HEALTH is an indian health service tribal urban indian health i t u pharmacy in Tishomingo, OK. The provider is 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. CHICKASAW NATION DIVISION OF HEALTH NPI is 1750406757. The provider is registered as an organization entity type.
The provider Is Doing Business As Tishomingo Indian Clinic Pharmacy.

The provider's business location address is:

817 E 6TH ST
TISHOMINGO, OK
ZIP 73460-800
Phone: (580) 371-2392
Fax: (580) 421-4552

The provider's authorized official is Zach Williams .
The authorized official title is Pharmacist and has the following contact phone number (580) 272-2710.

The CLIA number assigned to this NPI record is 37D0888227 - other with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 2/10/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy61-6174OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100244600BMEDICAIDOKLAHOMA
22074771OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.