FORT WASHAKIE HEALTH CENTER PHARMACY (NPI# 1336274026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336274026 |
| Entity Type | Organization |
| Organization Name | FORT WASHAKIE HEALTH CENTER PHARMACY |
| Other Organization Name | WIND RIVER SERVICE UNIT |
| Practice Address |
29 Blackcoal Dr Fort Washakie WY 82514 |
| Practice Telephone | 3073323924 |
| Practice Fax Number | 3073323949 |
| Mailing Telephone | 3073323924 |
| Mailing Fax Number | 3073323949 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2017-05-12 |
| Authorized Official Name | DR. CALVIN JAMES ANDERSON (CHIEF OF PHARMACY) |
| Authorized Official Telephone | 3073355997 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP NUMBER | 5203144 | 01 | |
| DEA NUMBER | AM7166057 | 01 |
| Other Name | Type Code |
|---|---|
| Wind River Service Unit | Other Name - Individual/Organization |
| Street Address |
29 BLACKCOAL DR |
| City | FORT WASHAKIE |
| State | WY |
| Zip Code | 82514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619136991 | Marion Gean Ute | Registered Nurse | 29 Blackcoal Dr, Fort Washakie, WY 82514 | 2008-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527819 | Melissa Rose Pine | Registered Nurse | 29 Blackcole Road, Fort Washakie, WY 82514 | 2019-09-19 |
| 1982116794 | Madonna Lee Kienlen | Peer Specialist | 215 Ethete Road, Ft. Washakie, WY 82514 | 2017-11-02 |
| 1649789025 | Rebecca Charlene Willis | Technician, Other | Fort Washakie Healt Center Lab Ihs 29 Black Coal Drive, Fort Washakie, WY 82514 | 2017-09-28 |
| 1033553185 | Pauline Elizabeth Powers-peprah | Family Medicine | 29 Black Cole, Fort Washakie, WY 82514 | 2013-04-19 |
| 1528319373 | Amanda L Schultz | Licensed Practical Nurse | 110 Sharpnose Road, Fort Washakie, WY 82514 | 2012-09-19 |
| 1770898140 | Kelly Lynne Pretty Weasel | Clinic/Center | 29 Blackcole Dr, Fort Washakie, WY 82514 | 2010-08-10 |
| 1285950170 | Debra Kay Waters | Technician, Pathology | Black Coal Rd. Bldg. 29, Ft. Washakie, WY 82514 | 2010-04-16 |
| 1881919751 | Shoshone & Arapaho Tribal Substance Abuse Court | Clinic/Center | 215 Ethete Rd, Fort Washakie, WY 82514 | 2010-04-02 |
| 1770814253 | Christopher G Nelson | Spec/Tech, Pathology | 29 Black Coal Rd, Ft. Washakie, WY 82514 | 2010-01-22 |
| 1922339449 | Nina Williams | Spec/Tech, Pathology | Black Coal Rd Bldg 29, Ft Washakie, WY 82514 | 2010-01-22 |
| Find all providers in zip 82514 | ||||
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | 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. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346700622 | Wind River Family & Community Health Care | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 510 Ethete Rd., Ethete, WY 82520 | 2019-03-22 |
| 1245365931 | Arapahoe Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 14 Great Plains Rd, Arapahoe, WY 82510 | 2007-02-22 |
| City | FORT WASHAKIE |
| Zip Code | 82514 |
Please comment or provide details below to improve the information on FORT WASHAKIE HEALTH CENTER PHARMACY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.