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General NPI Number Information
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NPI Number | 1790815363
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Entity Type | Organization
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Legal Business Name | PINE RIDGE IHS HOSPITAL PHARMACY
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | HIGHWAY 18 EAST
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City | PINE RIDGE
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State | SD
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Zip | 57770
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Country | US
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Telephone | 605-867-5131
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Fax | 605-867-3279
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Provider Business Mailing Address
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Address Line | 3117 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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