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General NPI Number Information
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NPI Number | 1801925060
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Entity Type | Organization
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Legal Business Name | SISSETON WAHPETON OYATE HEALTHCARE CENTER
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 100 LAKE TRAVERSE DR
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City | SISSETON
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State | SD
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Zip | 57262-7046
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Country | US
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Telephone | 605-698-7606
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Fax | 605-698-4270
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Provider Business Mailing Address
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Address Line | 3124 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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