Organization
WEWOKA IHS PHARMACY
Active
Other names
WEWOKA 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
INTERSECTION OF HWY 56 AND 270, WEWOKA, OK 74884
(405) 257-6281
(405) 257-2696
Mailing address
PO BOX 676729, DALLAS, TX 75267-6729
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
24-3295
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231960J
—
OK
05
—
1100231960J
—
OK
01
—
2076399
PK
—
Enumeration date
01/12/2007
Last updated
10/19/2016
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