Organization
CONFEDERATED TRIBES OF SILETZ
Active
Other names
Siletz Community Health Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA WILLIAMS (HEALTH DIRECTOR)
(541) 444-1030
Entity
Organization
Contact information
Practice address
200 GWEE-SHUT ROAD, SILETZ, OR 97380
(541) 444-1030
(541) 444-9695
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
(541) 444-1030
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
RP-0002621-CS
OR
332B00000X
Durable Medical Equipment & Medical Supplies
RP-0002621-CS
OR
3336C0002X
Clinic Pharmacy
RP-0002621-CS
OR
3336M0002X
Mail Order Pharmacy
RP-0002621-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051966
—
OR
Enumeration date
02/27/2007
Last updated
09/21/2022
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