Organization
DHHS US PUBLIC HEALTH SERVICE INDIAN HEALTH SERVICE
Active
Other names
Pawhuska Indian Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY D EDEN MPH (BUSINESS OFFICE MANAGER)
(918) 287-4491
Entity
Organization
Contact information
Practice address
101S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 287-4491
(918) 287-2347
Mailing address
715 GRANDVIEW AVE, PAWHUSKA, OK 74056
(918) 287-4491
(918) 287-2347
Taxonomy
Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100231960F
MEDICAID RX
OK
05
—
100689200D
—
OK
01
—
100700620N
MEDICAID CAP
OK
Enumeration date
09/27/2006
Last updated
08/31/2009
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