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General NPI Number Information
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NPI Number | 1124178017
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Entity Type | Organization
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Legal Business Name | PAWNEE IHS PHARMACY
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 1201 HERITAGE CIR
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City | PAWNEE
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State | OK
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Zip | 74058-3744
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Country | US
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Telephone | 918-762-2517
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Fax | 918-762-4614
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Provider Business Mailing Address
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Address Line | PO BOX 95435
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City | CLEVELAND
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State | OH
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Zip | 44101-0033
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Country | US
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Telephone | 918-762-2517
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Fax | 918-762-4614
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Authorized Official
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Title or Position | AREA PHARMACY CONSULTANT
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Name | KAILEEN SKIDGEL
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Credential | PHARMD
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Telephone | 918-762-6611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number | 521768
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License Number State | OK
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