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Organization

CHICKASAW NATION DIVISION OF HEALTH

Active
Other names
PURCELL INDIAN HEALTH CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
ZACH WILLIAMS DPH (PHARMACIST)
(580) 436-3980
Entity
Organization

Contact information

Practice address
1438 HARDCASTLE BLVD, PURCELL, OK 73080-8233
(580) 272-5710
(580) 272-5711
Mailing address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 421-4597
(580) 421-4598

Taxonomy

Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
474906
OK
333600000X
Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100689860C
OK
01
2076971
PK
Enumeration date
03/20/2007
Last updated
02/15/2017
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