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Organization
WEWOKA IHS PHARMACY
Active
Organization
WEWOKA IHS PHARMACY
Active
Other names
WEWOKA IHS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE PATTEN PHARMD (AREA PHARMACY CONSULTANT)
(405) 951-6035
Entity
Organization
Contact information
Practice address
INTERSECTION OF HWY 56 AND 270, WEWOKA, OK 74884
(405) 257-6281
(405) 257-2696
Mailing address
PO BOX 676729, DALLAS, TX 75267-6729
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
24-3295
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231960J
—
OK
05
—
1100231960J
—
OK
01
—
2076399
PK
—
Enumeration date
01/12/2007
Last updated
10/19/2016
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