Organization
PONCA TRIBE OF NEBRASKA
Active
Other names
Ponca Hills Health and Wellness Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD LEE (CHIEF EXECUTIVE OFFICER)
(402) 734-5275
Entity
Organization
Contact information
Practice address
1800 SYRACUSE AVE, NORFOLK, NE 68701-2458
(402) 371-8834
(402) 371-7564
Mailing address
2602 J ST, OMAHA, NE 68107-1643
(402) 734-5275
(402) 734-5708
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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