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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.

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Contact Information

PRAIRIE BAND POTAWATOMI NATION
11400 158TH RD
MAYETTA, KS  66509-8866
 Phone: 866-727-6330
 Fax: 785-966-8396
 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 PRAIRIE BAND POTAWATOMI NATION

NPI Number 1952323958
LBN Legal business name PRAIRIE BAND POTAWATOMI NATION
Authorized official MIKE CARPENTER - (CHIEF PHARMACIST)
Entity Organization
Organization subpart 1 Yes
Enumeration date 07/25/2006
Last updated 01/23/2018 - About 8 years ago
Identifiers
KS License # 2-2546
KS Medicaid 200259300B
Other 2027266 PK
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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