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General NPI Number Information
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NPI Number | 1568839470
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Entity Type | Organization
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Legal Business Name | OSAGE NATION SI-SI A-PE-TXA
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 316 E MAIN ST
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City | PAWHUSKA
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State | OK
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Zip | 74056-5218
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Country | US
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Telephone | 918-287-9373
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Fax | 918-287-1555
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Provider Business Mailing Address
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Address Line | 316 E MAIN ST
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City | PAWHUSKA
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State | OK
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Zip | 74056-5218
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Country | US
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Telephone | 918-287-9300
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Fax | 918-287-9343
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | HARRISON HUDGINS
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Credential |
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Telephone | 918-287-9335
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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 | 16-7405
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License Number State | OK
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