Citizen Potawatomi Nation West Clinic
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Shawnee, OK. Organization (NPI-2).
NPI number1598053993
StatusActive
Last updated in NPPESMay 18, 2026
Details
- NPI
- 1598053993
- Entity type
- Organization (NPI-2)
- Legal business name
- Citizen Potawatomi Nation West Clinic
- Organization subpart
- No
- Enumeration date
- Jul 19, 2011
- Certification date
- May 18, 2026
- Last updated
- May 18, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 105576 | OK | Yes |
Practice location
781 Grand Casino BlvdShawnee, OK 74804-1005
Phone 405-964-5770 · Fax 405-964-5785
Mailing address
781 Grand Casino BlvdShawnee, OK 74804-1005
Phone 405-964-5770 · Fax 405-964-5785
Authorized official
Aubry Bennett
Business Office Coordinator
4059644025
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