NPIMap

Organization Active NPI

Ponca Tribe of Nebraska

Doing business as Fred Leroy Health and Wellness Center

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Omaha, NE
National Provider Identifier
1356673040
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
PONCA TRIBE OF NEBRASKA
Doing business as
Fred Leroy Health and Wellness Center
Practice address
2602 J St
Omaha, NE 68107-1643
Phone
(402) 734-5275
Fax
(402) 734-5708
NPI assigned
Feb 4, 2010
Last updated
Feb 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dennis M Schufeldt, PHARM.D.NPI 1457484750
Title
Cheif Pharmacist
Phone
(402) 734-5275

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X NU Primary

Addresses

Primary practice location

2602 J St
Omaha, NE 68107-1643

Mailing address

2602 J St
Omaha, NE 68107-1643
Phone (402) 734-5275

Other names 1

  • FRED LEROY HEALTH AND WELLNESS CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ponca Tribe of Nebraska9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1356673040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071643",
            "telephone_number": "402-734-5275",
            "fax_number": "402-734-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071643",
            "telephone_number": "402-734-5275",
            "fax_number": "402-734-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCA TRIBE OF NEBRASKA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "SCHUFELDT",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHEIF PHARMACIST",
        "authorized_official_telephone_number": "402-734-5275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRED LEROY HEALTH AND WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.