Organization · NPI-2

Absentee Shawnee Tribal Health Authority, INC.

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Norman, OK

NPI number1699790543
StatusActive
Last updated in NPPESAug 12, 2026

Details

NPI
1699790543
Entity type
Organization (NPI-2)
Legal business name
Absentee Shawnee Tribal Health Authority, INC.
Organization subpart
No
Enumeration date
Jul 13, 2006
Certification date
Aug 12, 2026
Last updated
Aug 12, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy7-5950OKYes

Other names

  • Ast Little Axe Health Center Pharmacy (Other Name)

Practice location

15951 Little Axe Dr
Norman, OK 73026-9088

Phone 405-292-9530 · Fax 405-701-7930

Mailing address

15951 Little Axe Dr
Norman, OK 73026-9088

Phone 405-447-0300 · Fax 405-701-7631

Authorized official

Marty Lofgren
Executive/ Medical Director
4054470300

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