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General NPI Number Information
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NPI Number | 1447143532
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Entity Type | Organization
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Legal Business Name | CHOCTAW NATION OF OKLAHOMA
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1300 E MARTIN LUTHER KING DR
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City | BROKEN BOW
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State | OK
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Zip | 74728-4160
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Country | US
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Telephone | 918-567-7000
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Fax | 918-567-7180
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Provider Business Mailing Address
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Address Line | 1 CHOCTAW WAY
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City | TALIHINA
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State | OK
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Zip | 74571-2022
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Country | US
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Telephone | 918-567-7000
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Fax | 918-567-7180
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Authorized Official
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Title or Position | EXECUTIVE OFFICER - HEALTH
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Name | TODD A HALLMARK
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Credential |
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Telephone | 918-567-7115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 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 #4
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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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