| NPI | 1528424611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN OLAND Pharmacy Director 307-857-9490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2020-01-31 |