Organization
SAC & FOX NATION
Active
Organization
SAC & FOX NATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERI BROWN (BUSINESS OFFICE MANAGER)
(918) 968-9531
Entity
Organization
Contact information
Practice address
356110 E 930 RD, STROUD, OK 74079-5184
(918) 968-9531
(918) 968-9057
Mailing address
356110 E 930 RD, STROUD, OK 74079-5184
(918) 968-9531
(918) 968-9057
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100729660A
—
OK
01
—
730078966-001
BCBS OF OKLAHOMA
OK
Enumeration date
11/09/2006
Last updated
09/12/2019
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