NPIMap

Organization Active NPI

Confederated Tribes of Siletz

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Siletz, OR
National Provider Identifier
1891822003
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
License
RP-0002621-CS Issued in OR
Legal business name
CONFEDERATED TRIBES OF SILETZ
Doing business as
Siletz Community Health Clinic Pharmacy
Practice address
200 Gwee-Shut Road
Siletz, OR 97380
Phone
(541) 444-1030
Fax
(541) 444-9695
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Miranda Williams
Title
Health Director
Phone
(541) 444-1030

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X RP-0002621-CS OR Primary
Durable Medical Equipment & Medical Supplies 332B00000X RP-0002621-CS OR
Clinic Pharmacy 3336C0002X RP-0002621-CS OR
Mail Order Pharmacy 3336M0002X RP-0002621-CS OR

Addresses

Primary practice location

200 Gwee-Shut Road
Siletz, OR 97380

Mailing address

PO Box 320
Siletz, OR 97380-0320
Phone (541) 444-1030

Other identifiers 1

IdentifierTypeStateIssuer
051966MedicaidOR

Other names 1

  • Siletz Community Health Clinic Pharmacy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1891822003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320",
            "city": "SILETZ",
            "state": "OR",
            "postal_code": "973800320",
            "telephone_number": "541-444-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GWEE-SHUT ROAD",
            "city": "SILETZ",
            "state": "OR",
            "postal_code": "97380",
            "telephone_number": "541-444-1030",
            "fax_number": "541-444-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFEDERATED TRIBES OF SILETZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "541-444-1030"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "OR",
            "license": "RP-0002621-CS",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": "RP-0002621-CS",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OR",
            "license": "RP-0002621-CS",
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "OR",
            "license": "RP-0002621-CS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051966",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Siletz Community Health Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Siletz, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.