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Organization
SPIRIT LAKE HEALTH CENTER PHARMACY
Active
Organization
SPIRIT LAKE HEALTH CENTER PHARMACY
Active
Other names
SPIRIT LAKE HEALTH CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CUMMINGS (PHARMACY PROGRAM SPECIALIST)
(405) 951-6086
Entity
Organization
Contact information
Practice address
3883 74TH AVE NE, FORT TOTTEN, ND 58335
(701) 766-1612
(701) 766-1625
Mailing address
SPIRIT LAKE HEALTH CTR, 3100 SOLUTIONS CENTER, CHICAGO, IL 60677-3001
(701) 766-1612
(701) 766-1625
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
—
01051
—
ND
05
—
1061SP
—
ND
01
—
3503693
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/06/2007
Last updated
03/07/2013
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