NPIMap

Organization Active NPI

Absentee Shawnee Tribal Health Authority, Inc.

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Shawnee, OK
National Provider Identifier
1831294024
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
License
10-4263 Issued in OK
Legal business name
ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.
Practice address
2029 Gordon Cooper Dr
Shawnee, OK 74801-9005
Phone
(405) 878-5859
Fax
(405) 669-3099
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Marty Lofgren, MD, CPE
Title
Executive/ Medical Director
Phone
(405) 447-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X 10-4263 OK Primary

Addresses

Primary practice location

2029 Gordon Cooper Dr
Shawnee, OK 74801-9005

Mailing address

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

Other identifiers 1

IdentifierTypeStateIssuer
100699860FMedicaidOK

Other names 1

  • Absentee Shawnee Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Absentee Shawnee Tribal Health Authority Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1831294024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300",
            "fax_number": "405-701-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019005",
            "telephone_number": "405-878-5859",
            "fax_number": "405-669-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "LOFGREN",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "EXECUTIVE/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "405-447-0300",
        "authorized_official_credential": "MD, CPE"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "OK",
            "license": "10-4263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699860F",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Absentee Shawnee Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.