| NPI | 1952923104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN TERRY Secretary Of Health 918-756-9909 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |