Organization
THE CHICKASAW NATION EMPLOYEE CLINIC PHARMACY- ADA
Active
Other names
Chickasaw Nation Employee Clinic Pharmacy- Norman, Chickasaw Nation Employee Clinic Pharmacy-Ada, Chickasaw Nation Employee Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS DUANE SELLERS DPH (DIRECTOR OF TRIBAL PHARMACY SERVICE)
(580) 235-6419
Entity
Organization
Contact information
Practice address
1007 N COUNTRY CLUB RD, ADA, OK 74820-2847
(580) 421-8775
(580) 421-8789
Mailing address
1007 N COUNTRY CLUB RD, ADA, OK 74820-2847
(580) 421-8775
(580) 421-8789
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200436850A
—
OK
01
—
2135608
PK
—
Enumeration date
06/15/2012
Last updated
06/17/2024
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