Organization
ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.
Active
Other names
Absentee Shawnee Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY LOFGREN MD, CPE (MEDICAL DIRECTOR)
(405) 447-0300
Entity
Organization
Contact information
Practice address
2029 GORDON COOPER DR, SHAWNEE, OK 74801-9005
(405) 878-5859
(405) 669-3099
Mailing address
15951 LITTLE AXE DR, NORMAN, OK 73026-9088
(405) 447-0300
(405) 701-7914
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
10-4263
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100699860F
—
OK
Enumeration date
09/13/2006
Last updated
10/27/2025
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