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Organization

FORT DEFIANCE INDIAN HOSP PHARMACY

Active
Other names
FORT DEFIANCE INDIAN HOSP PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA SCHWEITZER PHARMD (IHS PHARMACY CONSULTANT)
(602) 364-5277
Entity
Organization

Contact information

Practice address
INTERSECTION OF HWY 12 AND HWY 7, FORT DEFIANCE, AZ 86504
(928) 729-8328
(928) 729-8348
Mailing address
PO BOX 31001-0654, PASADENA, CA 91110-0654

Taxonomy

Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
333600000X
Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0324424
NCPDP PROVIDER IDENTIFICATION NUMBER
05
66645
AZ
Enumeration date
03/05/2007
Last updated
01/29/2010
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