Organization
CITIZEN POTAWATOMI NATION
Active
Organization
CITIZEN POTAWATOMI NATION
Active
Other names
Citizen Potawatomi Nation Clinic Pharmacy, citizen potawatomi nation clinic pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AUBRY BENNETT CPC-A (BUSINESS OFFICE COORDINATOR)
(405) 964-4025
Entity
Organization
Contact information
Practice address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 273-5236
(405) 273-2392
Mailing address
2307 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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100244300A
—
OK
Enumeration date
07/31/2006
Last updated
05/18/2026
Update your record
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