Provider Demographics
NPI:1962621334
Name:CHEYENNE AND ARAPAHO TRIBES OF OKLAHOMA
Entity type:Organization
Organization Name:CHEYENNE AND ARAPAHO TRIBES OF OKLAHOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLBEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-422-7681
Mailing Address - Street 1:100 RED MOON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CONCHO
Mailing Address - State:OK
Mailing Address - Zip Code:73022-2541
Mailing Address - Country:US
Mailing Address - Phone:405-422-7681
Mailing Address - Fax:405-262-3423
Practice Address - Street 1:100 RED MOON CIRCLE
Practice Address - Street 2:
Practice Address - City:CONCHO
Practice Address - State:OK
Practice Address - Zip Code:73022
Practice Address - Country:US
Practice Address - Phone:405-422-7688
Practice Address - Fax:405-262-3423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332H00000XSuppliersEyewear Supplier