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Organization
KICKAPOO TRIBAL HEALTH CENTER
Active
Organization
KICKAPOO TRIBAL HEALTH CENTER
Active
Other names
KICKAPOO TRIBAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE IRION (HEALTH DIRECTOR)
(405) 964-2081
Entity
Organization
Contact information
Practice address
105365 S. HWY 102, BUILDING M, MCLOUD, OK 74851
(405) 964-2081
(405) 964-7160
Mailing address
105365 S. HWY 102, BUILDING M, MCLOUD, OK 74851
(405) 964-2081
(405) 964-7160
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100245200A
—
OK
01
—
3721809
NABP
OK
Enumeration date
11/02/2006
Last updated
10/06/2025
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