NPIMap

Organization Active NPI

Fort Yates Indian Hosp Pharmacy

Doing business as Fort Yates Indian Hospital Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Fort Yates, ND
National Provider Identifier
1770613325
Registry record updated Mar 7, 2013
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
FORT YATES INDIAN HOSP PHARMACY
Doing business as
Fort Yates Indian Hospital Pharmacy
Practice address
1010 N River Rd
Fort Yates, ND 58538
Phone
(701) 854-8251
Fax
(701) 854-3523
NPI assigned
Mar 6, 2007
Last updated
Mar 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Authorized official

Name
James Cummings, PHARMD
Title
Pharmacy Program Specialist
Phone
(405) 951-6086

Specialties & licenses 1

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

Addresses

Primary practice location

1010 N River Rd
Fort Yates, ND 58538

Mailing address

3113 Solutions Ctr
Chicago, IL 60677-3001

Other identifiers 4

IdentifierTypeStateIssuer
5549040MedicaidSD
3503833OtherNCPDP PROVIDER IDENTIFICATION NUMBER
001058MedicaidND
1058FOMedicaidND

Other names 1

  • FORT YATES INDIAN HOSPITAL PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fort Yates IHS Hospital16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

3113 Solutions Ctr
Chicago, IL 60677

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1770613325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606773001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N RIVER RD",
            "city": "FORT YATES",
            "state": "ND",
            "postal_code": "58538",
            "telephone_number": "701-854-8251",
            "fax_number": "701-854-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT YATES INDIAN HOSP PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PHARMACY PROGRAM SPECIALIST",
        "authorized_official_telephone_number": "405-951-6086",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5549040",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3503833",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001058",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1058FO",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORT YATES INDIAN HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Yates, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; 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.