National Provider Identifier Database

PONCA TRIBE OF NEBRASKA
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

PONCA TRIBE OF NEBRASKA
2602 J ST
FRED LEROY HEALTH AND WELLNESS CENTER PHARMACY
OMAHA, NE68107-1643
Phone: 402-734-5275
Fax: 402-733-3487
Website:
Specialty Taxonomy Code
* Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

* Indicates primary specialty

NPI Profile & details for PONCA TRIBE OF NEBRASKA

NPI Number 1760778385
Legal business name
LBN
PONCA TRIBE OF NEBRASKA
Authorized official DONALD LEE - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart Yes
Enumeration date 06/22/2011
Last updated 06/22/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • NE License #: 2884
  • Other: 2817964 NCPDP
  • NE Other: 2884 PHARMACY LICENSE NUMBER

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.

Reviews for PONCA TRIBE OF NEBRASKA

There are currently no reviews for PONCA TRIBE OF NEBRASKA


NPIdb - Home
v2.201