Organization
PAWHUSKA IHS PHARMACY
Active
Other names
PAWHUSKA IHS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE PATTEN PHARMD (AREA PHARMACY CONSULTANT)
(405) 951-6035
Entity
Organization
Contact information
Practice address
715 GRANDVIEW AVE, PAWHUSKA, OK 74056-3201
(918) 287-4491
(918) 287-2347
Mailing address
PO BOX 676748, DALLAS, TX 75267-6748
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
162939
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231960F
—
OK
01
—
3717925
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/01/2005
Last updated
03/11/2013
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