| NPI | 1902012305 |
|---|---|
| Other Name | SAC & FOX TRIBE OF THE MISSISSIPPI IN IOWA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PATRICK BOLTE Chief Pharmacist 641-484-4667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2011-09-07 |