NPIMap

Organization Active NPI

Pawhuska IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Pawhuska, OK
National Provider Identifier
1952303190
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
License
162939 Issued in OK
Legal business name
PAWHUSKA IHS PHARMACY
Doing business as
Pawhuska IHS Pharmacy
Practice address
715 Grandview Ave
Pawhuska, OK 74056-3201
Phone
(918) 287-4491
Fax
(918) 287-2347
NPI assigned
Jun 1, 2005
Last updated
Mar 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Authorized official

Name
Tracie Patten, PHARMD
Title
Area Pharmacy Consultant
Phone
(405) 951-6035

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X 162939 OK Primary

Addresses

Primary practice location

715 Grandview Ave
Pawhuska, OK 74056-3201

Mailing address

PO Box 676748
Dallas, TX 75267-6748

Other identifiers 2

IdentifierTypeStateIssuer
3717925OtherNCPDP PROVIDER IDENTIFICATION NUMBER
100231960FMedicaidOK

Other names 1

  • PAWHUSKA IHS PHARMACY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1952303190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 676748",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752676748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 GRANDVIEW AVE",
            "city": "PAWHUSKA",
            "state": "OK",
            "postal_code": "740563201",
            "telephone_number": "918-287-4491",
            "fax_number": "918-287-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAWHUSKA IHS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "PATTEN",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_title_or_position": "AREA PHARMACY CONSULTANT",
        "authorized_official_telephone_number": "405-951-6035",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "OK",
            "license": "162939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3717925",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100231960F",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAWHUSKA IHS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pawhuska, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.