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General NPI Number Information
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NPI Number | 1457447609
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Entity Type | Organization
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Legal Business Name | INDIAN HEALTH CARE RESOURCE CENTER OF TULSA, INC.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 530 S. PEORIA AVENUE
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City | TULSA
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State | OK
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Zip | 74120
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Country | US
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Telephone | 918-588-1900
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Fax | 918-382-1285
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Provider Business Mailing Address
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Address Line | 550 S. PEORIA AVENUE
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City | TULSA
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State | OK
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Zip | 74120-3825
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Country | US
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Telephone | 918-588-1900
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Fax | 918-582-6405
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Authorized Official
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Title or Position | CEO
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Name | MRS. CARMELITA SKEETER
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Credential |
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Telephone | 918-382-1201
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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