Kickapoo Tribal Pharmacy

LBN: Kickapoo Tribal Health Center
Kickapoo Tribal Pharmacy is an health care organization with primary practice located at 105365 S. Hwy 102 Building M, Mcloud OK 74851. The organization recently has only one registered license in Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, which is considered as the primary health care specialty. Kickapoo Tribal Health Center can be contacted via phone (405) 964-2081, or through Mahtapene, Janetta via phone (405) 964-2081.

Contact Information

Primary practice address
105365 S. Hwy 102 Building M Mcloud OK 74851
Phone: (405) 964-2081
Fax: (405) 964-7160
Website:
Map and Directions
Authorized official contact:
Name: Mahtapene, Janetta
Phone: (405) 964-2081

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

Profile Details

NPI number 1194803346
LBN Legal business name Kickapoo Tribal Health Center
DBA Doing business as Kickapoo Tribal Pharmacy
Authorized official Mahtapene, Janetta
Entity Organization
Organization subpart 1 No
Enumeration date Nov 2nd, 2006
Last updated Nov 2nd, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194803346 NPPES
Oklahoma Other 3721809 NABP
Oklahoma MEDICAID 100245200A NABP

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