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Organization
WHITE CLOUD IHS PHARMACY
Active
Organization
WHITE CLOUD IHS PHARMACY
Active
Other names
WHITE CLOUD IHS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE PATTEN PHARMD (IHS AREA PHARMACY CONSULTANT)
(405) 951-6035
Entity
Organization
Contact information
Practice address
3313 THRASHER RD, WHITE CLOUD, KS 66094-4028
(785) 595-3450
(785) 595-3493
Mailing address
PO BOX 676715, DALLAS, TX 75267-6715
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
112656
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1717492
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/11/2007
Last updated
02/20/2013
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