| NPI | 1871663203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERI BROWN Business Office Manager 918-968-9531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2019-09-12 |