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Organization

EAGLE BUTTE IHS HOSPITAL PHARMACY

Active
Other names
EAGLE BUTTE IHS HOSPITAL PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES CUMMINGS (PHARMACY PROGRAM SPECIALIST)
(405) 951-6086
Entity
Organization

Contact information

Practice address
317 MAIN ST, EAGLE BUTTE, SD 57625
(605) 964-0654
(605) 964-1110
Mailing address
3109 SOLUTIONS CTR, CHICAGO, IL 60677-3001

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
01
4304933
NCPDP PROVIDER IDENTIFICATION NUMBER
05
5549080
SD
Enumeration date
02/27/2007
Last updated
03/07/2013
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