Organization
CHEROKEE NATION
Active
Other names
THREE RIVERS HEALTH CENTER RX
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE GRAHAM MHA (DIR., HEALTH EDUCATION & STAFF DEV)
(539) 234-1977
Entity
Organization
Contact information
Practice address
1001 S 41ST ST E, ST E, MUSKOGEE, OK 74403-6253
(918) 687-0201
(918) 687-0665
Mailing address
CHEROKEE NATION, DEPT 2269, TULSA, OK 74182-0001
(918) 453-5000
(918) 458-6222
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
45259
OK
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100239109F
—
OK
01
—
2076237
PK
—
Enumeration date
06/21/2006
Last updated
11/15/2022
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