Organization
SAC & FOX NATION
Active
Other names
BLACK HAWK HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE RICH (PHARMACY MANAGER)
(918) 968-9531
Entity
Organization
Contact information
Practice address
RR 2 BOX 247, STROUD, OK 74079-9652
(918) 968-9531
(918) 968-0113
Mailing address
RR 2 BOX 247, STROUD, OK 74079-9652
(918) 968-9531
(918) 968-0113
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
—
100729660C
—
OK
01
—
3723269
NCPDP
OK
Enumeration date
08/13/2006
Last updated
06/12/2008
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