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Organization

IOWA TRIBE OF OKLAHOMA

Active
Other names
PERKINS FAMILY CLINIC PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA DAWN DAUGHERTY (DIRECTOR OF HEALTH)
(405) 547-2473
Entity
Organization

Contact information

Practice address
509 E HIGHWAY 33, PERKINS, OK 74059-4129
(405) 547-2473
(405) 547-2925
Mailing address
PO BOX 460, PERKINS, OK 74059-0460
(405) 547-2473
(405) 547-2925

Taxonomy

Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
8-5151
OK
333600000X
Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100707800B
OK
01
2077058
PK
Enumeration date
07/24/2006
Last updated
09/18/2019
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