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General NPI Number Information
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NPI Number | 1093546574
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Entity Type | Organization
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Legal Business Name | CREEK NATION HOSPITAL & CLINICS
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 10153 E 79TH ST STE 102
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City | TULSA
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State | OK
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Zip | 74133-4637
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Country | US
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Telephone | 855-771-4321
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Fax | 918-756-2464
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Provider Business Mailing Address
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Address Line | PO BOX 400
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City | OKMULGEE
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State | OK
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Zip | 74447-0400
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Country | US
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Telephone | 918-756-9909
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Fax | 918-756-2464
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | DUSTY JAMES ALLEN
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Credential | PHARMD
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Telephone | 918-756-9909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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