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Prairie Band Potawatomi Nation
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Mayetta, Kansas
NPI 1952323958

Prairie Band Potawatomi Nation is a Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy based in Mayetta, KS. Prairie Band Potawatomi Nation practices in Mayetta, KS. The NPI Number for Prairie Band Potawatomi Nation is 1952323958 and holds a License No. 2-2546 (Kansas).

The current practice location address for Prairie Band Potawatomi Nation is 11400 158Th Rd, Mayetta, KS and can be reached out via phone at 866-727-6330 and via fax at 785-966-8396.

Location: 11400 158Th Rd, Mayetta, KS, 66509-0249
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1952323958
Provider Name
Prairie Band Potawatomi Nation
Credential
Provider Entity Type
Organization
Address
11400 158Th Rd, Mayetta, KS, 66509-0249
Phone Number
866-727-6330
Fax Number
785-966-8396
Provider Enumeration Date
07/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2027266 01 PK
200259300B 05 KS
institution
Provider Business Practice Location Address Details
Address
11400 158Th Rd
City
Mayetta
State
Kansas
Zip
66509-8866
Phone Number
866-727-6330
Fax Number
785-966-8396
person
Provider Business Mailing Address Details
Address
11400 158Th Rd
City
Mayetta
State
Kansas
Zip
66509-8866
Phone Number
866-727-6330
Fax Number
785-966-8396
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.
2-2546 (Kansas)
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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