# NORTHWEST CENTER FOR BEHAVIORAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NORTHWEST CENTER FOR BEHAVIORAL HEALTH
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710174107
- **Authorized official:** CHRISTEN SCHMIDT DPH (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (580) 766-2311

## Contact information

- **Practice address:** 193461 E CT RD 304, FORT SUPPLY, OK 73841-0001
- **Practice address phone:** (580) 766-2311
- **Practice address fax:** (580) 766-2316
- **Mailing address:** PO BOX 1, FORT SUPPLY, OK 73841-0001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | 44-2593 | OK | Yes |

## Other

- **Enumeration date:** 09/28/2007
- **Last updated:** 12/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100704080A | — | OK |
| 05 | — | 100704080B | — | OK |
| 01 | — | 2074624 | PK | — |