Provider Demographics
NPI:1093546574
Name:CREEK NATION HOSPITAL & CLINICS
Entity type:Organization
Organization Name:CREEK NATION HOSPITAL & CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:DUSTY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:918-756-9909
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-0400
Mailing Address - Country:US
Mailing Address - Phone:918-756-9909
Mailing Address - Fax:918-756-2464
Practice Address - Street 1:10153 E 79TH ST STE 102
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4637
Practice Address - Country:US
Practice Address - Phone:855-771-4321
Practice Address - Fax:918-756-2464
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CREEK NATION HOSPITAL & CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy