Provider Demographics
NPI:1194590760
Name:CREEK NATION HOSPITAL & CLINICS
Entity type:Organization
Organization Name:CREEK NATION HOSPITAL & CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-233-9550
Mailing Address - Street 1:MCN PHARMACY DEPT #1249
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74182-0001
Mailing Address - Country:US
Mailing Address - Phone:918-756-9906
Mailing Address - Fax:918-756-2464
Practice Address - Street 1:2900 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-4078
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:2023-11-23
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy