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Organization
PAWHUSKA IHS PHARMACY
Active
Organization
PAWHUSKA IHS PHARMACY
Active
Other names
PAWHUSKA 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
715 GRANDVIEW AVE, PAWHUSKA, OK 74056-3201
(918) 287-4491
(918) 287-2347
Mailing address
PO BOX 676748, DALLAS, TX 75267-6748
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
162939
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231960F
—
OK
01
—
3717925
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/01/2005
Last updated
03/11/2013
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