| Citizen Potawatomi Nation Clinic Pharmacy | |
|
2307 S Gordon Cooper Dr Shawnee OK 74801-9007 | |
| (405) 273-5236 | |
| (405) 273-2392 |
| Full Name | Citizen Potawatomi Nation Clinic Pharmacy |
|---|---|
| Speciality | Clinic/center |
| Location | 2307 S Gordon Cooper Dr, Shawnee, Oklahoma |
| Authorized Official Name and Position | John Joseph Lareau (PHARMACY COORDINATOR) |
| Authorized Official Contact | 4052735236 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Citizen Potawatomi Nation Clinic Pharmacy 2307 S Gordon Cooper Dr Shawnee OK 74801-9007 Ph: (405) 273-5236 | Citizen Potawatomi Nation Clinic Pharmacy 2307 S Gordon Cooper Dr Shawnee OK 74801-9007 Ph: (405) 273-5236 |
| NPI Number | 1689680670 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689680670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 10-4078 (Oklahoma) | Primary |
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