| NPI | 1790833564 |
|---|---|
| Doing Business As | CHOCTAW NATION HEALTH CLINIC-IDABEL RX |
| Entity Type | Organization |
| Authorized Contact | TERESA K JACKSON Administrator 918-567-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: OK 255013) |
| Additional Taxonomies | 261Q00000X (Licence: OK 255013) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2013-04-17 |