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CITIZEN POTAWATOMI NATION, AHC Facilities / Federally Qualified Health Center (FQHC)

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Stethoscope
Reviews Information on CITIZEN POTAWATOMI NATION
NPI Number 1881981744
State Identifier(s) Oklahoma Medicaid #100244300G
Oklahoma Medicaid #100211300E
Oklahoma Medicaid #100244300F
Oklahoma Medicare OSCAR Certification #371877
Group Name CITIZEN POTAWATOMI NATION
Doing business as CITIZEN POTAWATOMI NATION WEST CLINIC
Credentials - Lic #: ()
Mailing Address Confidential
Business Address 781 GRAND CASINO BLVD
SHAWNEE, OK 74804-1005

Phone (405) 964-5770 Fax (405) 964-5785
Name TIM TALL CHIEF - (DIRECTOR OF HEALTH SERVICES)
Primary Specialty AHC Facilities / Federally Qualified Health Center (FQHC)
Additional Specialties
Last Modified 09/05/2012
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