Organization
CHICKASAW NATION DIVISION OF HEALTH
Active
Other names
Chickasaw Nation Medical Center Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ZACH WILLIAMS (PHARMACIST)
(580) 436-3980
Entity
Organization
Contact information
Practice address
1904 CARL ALBERT BLVD STE A, ADA, OK 74820-3493
(580) 272-5710
(580) 272-5711
Mailing address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 436-3980
(580) 421-4598
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
23-5511
OK
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124048
PK
—
01
—
23-8479
STATE PHARMACY LICENSE
OK
Enumeration date
03/10/2010
Last updated
11/18/2022
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