Organization
CHEROKEE NATION
Active
Other names
Vinita Health Center Pharmacy
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
27371 S 4410 RD, VINITA, OK 74301-7953
(918) 256-4848
(918) 256-4594
Mailing address
DEPT 2269, TULSA, OK 74182-0001
(918) 453-5636
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
37-6011
OK
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100239190B
—
OK
01
—
2136086
PK
—
Enumeration date
07/19/2012
Last updated
11/15/2022
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