Provider Demographics
NPI:1821269168
Name:CREEK NATION HOSPITAL & CLINICS
Entity Type:Organization
Organization Name:CREEK NATION HOSPITAL & CLINICS
Other - Org Name:CREEK NATION COMM HOSP S B
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:AARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-756-3334
Mailing Address - Street 1:FNB DEPT 001
Mailing Address - Street 2:PO BOX 1312
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-1312
Mailing Address - Country:US
Mailing Address - Phone:918-756-4333
Mailing Address - Fax:918-756-3993
Practice Address - Street 1:309 NORTH 14TH STREET
Practice Address - Street 2:
Practice Address - City:OKEMAH
Practice Address - State:OK
Practice Address - Zip Code:74859-2028
Practice Address - Country:US
Practice Address - Phone:918-623-1424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CREEK NATION HOSPITAL & CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-14
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2307275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37Z333Medicare Oscar/Certification