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General NPI Number Information
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NPI Number | 1366455420
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Entity Type | Organization
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Legal Business Name | SAC & FOX NATION
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | RR 2 BOX 247
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City | STROUD
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State | OK
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Zip | 74079-9652
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Country | US
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Telephone | 918-968-9531
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Fax | 918-968-0113
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Provider Business Mailing Address
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Address Line | RR 2 BOX 247
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City | STROUD
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State | OK
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Zip | 74079-9652
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Country | US
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Telephone | 918-968-9531
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Fax | 918-968-0113
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MS. JANE RICH
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Credential |
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Telephone | 918-968-9531
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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 |
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License Number State |
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