National Provider Identifier Database

PRAIRIE BAND POTAWATOMI NATION
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

PRAIRIE BAND POTAWATOMI NATION
11400 158TH RD
MAYETTA, KS66509-8866
Phone: 866-727-6330
Fax: 785-966-8396
Website:
Specialty Taxonomy Code
* Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

* Indicates primary specialty

NPI Profile & details for PRAIRIE BAND POTAWATOMI NATION

NPI Number 1952323958
Legal business name
LBN
PRAIRIE BAND POTAWATOMI NATION
Authorized official MIKE CARPENTER - (CHIEF PHARMACIST)
Entity Organization
Organization subpart Yes
Enumeration date 07/25/2006
Last updated 01/23/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • KS License #: 2-2546
  • KS Medicaid: 200259300B
  • Other: 2027266 PK

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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