1861889123 NPI number — CREEK NATION HOSPITAL & CLINICS

Table of content: DR. JOHN MICHAEL CASTRO PHARMD, BS, RPH (NPI 1861153876)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861889123 NPI number — CREEK NATION HOSPITAL & CLINICS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CREEK NATION HOSPITAL & CLINICS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861889123
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT 1038
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74182-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-756-4333
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 MORRIS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OKMULGEE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74447-6429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-756-4233
Provider Business Practice Location Address Fax Number:
918-756-5968
Provider Enumeration Date:
04/23/2015

Additional Information

Authorized Official

Authorized Official Last Name:
TERRY
Authorized Official First Name:
SHAWN
Authorized Official Middle Name:
Authorized Official Title or Position:
SECRETARY OF HEALTH
Authorized Official Telephone Number:
918-756-4333

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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