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Citizen Potawatomi Nation West Clinic
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Shawnee, Oklahoma
NPI 1598053993

Citizen Potawatomi Nation West Clinic is a Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy based in Shawnee, OK. Citizen Potawatomi Nation West Clinic practices in Shawnee, OK. The NPI Number for Citizen Potawatomi Nation West Clinic is 1598053993 and holds a License No. 105576 (Oklahoma).

The current practice location address for Citizen Potawatomi Nation West Clinic is 781 Grand Casino Blvd, Shawnee, OK and can be reached out via phone at 405-964-5770 and via fax at 405-964-5785.

Location: 781 Grand Casino Blvd, Shawnee, OK, 74804-1005
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598053993
Provider Name
Citizen Potawatomi Nation West Clinic
Credential
Provider Entity Type
Organization
Address
781 Grand Casino Blvd, Shawnee, OK, 74804-1005
Phone Number
405-964-5770
Fax Number
405-964-5785
Provider Enumeration Date
07/19/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100244300D 05 OK
institution
Provider Business Practice Location Address Details
Address
781 Grand Casino Blvd
City
Shawnee
State
Oklahoma
Zip
74804-1005
Phone Number
405-964-5770
Fax Number
405-964-5785
person
Provider Business Mailing Address Details
Address
781 Grand Casino Blvd
City
Shawnee
State
Oklahoma
Zip
74804-1005
Phone Number
405-964-5770
Fax Number
405-964-5785
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.
105576 (Oklahoma)
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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