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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 Specialty Code Provider Type

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

332800000X 87 All Other Suppliers
Indicates primary specialty

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

NPI Number 1386464402
LBN Legal business name SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Authorized official ELISE JOHNSON - (TRIBAL HEALTH DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/14/2024
Last updated 10/14/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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