# CHICKASAW NATION DIVISION OF HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chickasaw Nation Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396923280
- **Authorized official:** DENISE CARPENTER (CONTRACT MANAGEMENT COORDINATOR)
- **Authorized official phone:** (580) 421-4570

## Contact information

- **Practice address:** 1921 STONECIPHER BLVD, ADA, OK 74820
- **Practice address phone:** (580) 436-3980
- **Practice address fax:** (580) 421-6283
- **Mailing address:** 1921 STONECIPHER BLVD, ADA, OK 74820-3439
- **Mailing address phone:** (580) 421-4570
- **Mailing address fax:** (580) 421-6283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | EMS300 | OK | Yes |

## Other

- **Enumeration date:** 02/04/2008
- **Last updated:** 07/10/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100747670E | — | OK |
| 01 | — | EMS300 | STATE LICENSE | OK |