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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.

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Contact Information

PONCA TRIBE OF NEBRASKA
2602 J ST
FRED LEROY HEALTH AND WELLNESS CENTER PHARMACY
OMAHA, NE  68107-1643
 Phone: 402-734-5275
 Fax: 402-733-3487
 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 PONCA TRIBE OF NEBRASKA

NPI Number 1760778385
LBN Legal business name PONCA TRIBE OF NEBRASKA
Authorized official DONALD LEE - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/22/2011
Last updated 06/22/2011 - About 15 years ago
Identifiers
NE License # 2884
Other 2817964 NCPDP
NE Other 2884 PHARMACY LICENSE NUMBER
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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