Organization
ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.
Active
Other names
AST Little Axe Health Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY LOFGREN MD, CPE (MEDICAL DIRECTOR)
(405) 447-0300
Entity
Organization
Contact information
Practice address
15951 LITTLE AXE DR, NORMAN, OK 73026-9088
(405) 447-0300
(405) 701-7631
Mailing address
15951 LITTLE AXE DR, NORMAN, OK 73026-9088
(405) 447-0300
(405) 701-7631
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
—
100699860B
—
OK
Enumeration date
04/20/2021
Last updated
10/27/2025
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