| NPI | 1801058748 |
|---|---|
| Doing Business As | KICKAPOO NATION HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | PAUL KELLY AUSTIN Pharmicist 785-486-2154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2012-10-26 |