Organization
CITIZEN POTAWATOMI NATION
Active
Other names
citizen potawatomi nation clinic pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN JOSEPH LAREAU DPH (PHARMACY COORDINATOR)
(405) 273-5236
Entity
Organization
Contact information
Practice address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 273-5236
(405) 273-2392
Mailing address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 273-5236
(405) 273-2392
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
10-4078
OK
Other
Enumeration date
07/31/2006
Last updated
08/22/2020
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