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General NPI Number Information
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NPI Number | 1720117740
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Entity Type | Organization
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Legal Business Name | KYLE IHS CLINIC PHARMACY
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 1000 HEALTH CENTER CIRCLE
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City | KYLE
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State | SD
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Zip | 57752
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Country | US
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Telephone | 605-455-8225
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Fax | 605-455-2808
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Provider Business Mailing Address
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Address Line | 3103 SOLUTIONS CTR
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City | CHICAGO
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State | IL
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Zip | 60677-3001
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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 | PHARMACY PROGRAM SPECIALIST
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Name | JAMES CUMMINGS
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Credential | PHARMD
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Telephone | 405-951-6086
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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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