Healthcare Provider Details

I. General information

NPI: 1801803846
Provider Name (Legal Business Name): CHEROKEE NATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S J T STITES ST
SALLISAW OK
74955-9302
US

IV. Provider business mailing address

CHEROKEE NATION DEPT 2269
TULSA OK
74182-0001
US

V. Phone/Fax

Practice location:
  • Phone: 918-775-9159
  • Fax: 918-458-1211
Mailing address:
  • Phone: 918-458-6222
  • Fax: 918-458-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number34-3700
License Number StateOK

VIII. Authorized Official

Name: MICHELLE GRAHAM
Title or Position: DIR., HEALTH EDUCATION & STAFF DEV
Credential: MHA
Phone: 539-234-1977