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General NPI Number Information
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NPI Number | 1326198219
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Entity Type | Organization
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Legal Business Name | WATONGA IHS PHARMACY
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1305 CLARENCE NASH RD.
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City | WATONGA
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State | OK
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Zip | 73772
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Country | US
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Telephone | 580-623-4991
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Fax | 580-623-5490
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Provider Business Mailing Address
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Address Line | 1305 CLARENCE NASH RD.
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City | WATONGA
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State | OK
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Zip | 73772
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OCA PHARMACY CONSULTANT
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Name | KAILEEN SKIDGEL
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Credential |
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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 | 49-2937
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License Number State | OK
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