National Provider Identifier Database

SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.


Contact Information

SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
114 LAKE TRAVERSE DR STE 102
SISSETON, SD57262-7046
Phone: 833-674-3444
Fax:
Website:
Specialty Taxonomy Code
* Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

* Indicates primary specialty

NPI Profile & details for SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION

NPI Number 1386464402
Legal business name
LBN
SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Authorized official ELISE JOHNSON - (TRIBAL HEALTH DIRECTOR)
Entity Organization
Organization subpart Yes
Enumeration date 10/14/2024
Last updated 10/14/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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