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Wagner Indian Health Care Pharmacy
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Wagner, South Dakota
NPI 1548390115

Wagner Indian Health Care Pharmacy is a Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy based in Chicago, SD. Wagner Indian Health Care Pharmacy practices in Wagner, SD. The NPI Number for Wagner Indian Health Care Pharmacy is 1548390115 and holds a License No. 3860 (South Dakota).

The current practice location address for Wagner Indian Health Care Pharmacy is 111 Washington Ave Nw, Wagner, SD and can be reached out via phone at 605-384-3621 and via fax at 605-384-5229. You can also correspond with Wagner Indian Health Care Pharmacy through the mailing address at 3116 SOLUTIONS CTR, CHICAGO, IL - 60677-3001 (mailing address contact number: ).

Location: 111 Washington Ave Nw, Wagner, SD, 60677-3001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1548390115
Provider Name
Wagner Indian Health Care Pharmacy
Credential
Provider Entity Type
Organization
Address
111 Washington Ave Nw, Wagner, SD, 60677-3001
Phone Number
605-384-3621
Fax Number
605-384-5229
Provider Enumeration Date
03/06/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4304844 01 NCPDP PROVIDER IDENTIFICATION NUMBER
SD5540030 05 SD
institution
Provider Business Practice Location Address Details
Address
111 Washington Ave Nw
City
Wagner
State
South Dakota
Zip
57380-4300
Phone Number
605-384-3621
Fax Number
605-384-5229
person
Provider Business Mailing Address Details
Address
3116 Solutions Ctr
City
Chicago
State
Illinois
Zip
60677-3001
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
3860 (South Dakota)
Definition
An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
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