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Organization
CHOCTAW NATION OF OKLAHOMA
Active
Organization
CHOCTAW NATION OF OKLAHOMA
Active
Other names
Choctaw Nation Rubin White Poteau Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TODD A HALLMARK (EXECUTIVE OFFICER - DEPT OF HEALTH)
(918) 567-7115
Entity
Organization
Contact information
Practice address
109 KERR AVE, POTEAU, OK 74953-5270
(008) 349-7026
(918) 567-7180
Mailing address
ONE CHOCTAW WAY, TALIHINA, OK 74571
(800) 349-7026
(918) 567-7180
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100244980B
—
OK
05
—
100244980Q
—
OK
01
—
19-8533
OK STATE BOARD OF PHARMACY
OK
01
—
3721479
NCPDP
—
Enumeration date
01/04/2007
Last updated
08/08/2025
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