Organization
SPIRIT LAKE HEALTH CENTER PHARMACY
Active
Other names
SPIRIT LAKE HEALTH CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CUMMINGS (PHARMACY PROGRAM SPECIALIST)
(405) 951-6086
Entity
Organization
Contact information
Practice address
3883 74TH AVE NE, FORT TOTTEN, ND 58335
(701) 766-1612
(701) 766-1625
Mailing address
SPIRIT LAKE HEALTH CTR, 3100 SOLUTIONS CENTER, CHICAGO, IL 60677-3001
(701) 766-1612
(701) 766-1625
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
—
01051
—
ND
05
—
1061SP
—
ND
01
—
3503693
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/06/2007
Last updated
03/07/2013
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