KLAMATH TRIBAL HEALTH & FAMILY SERVICES (NPI# 1639290778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639290778 |
| Entity Type | Organization |
| Organization Name | KLAMATH TRIBAL HEALTH & FAMILY SERVICES |
| Other Organization Name | KLAMATH TRIBAL HEALTH PHARMACY |
| Practice Address |
330 S Chiloquin Blvd Chiloquin OR 97624-6747 |
| Mailing Address |
Po Box 490 Chiloquin OR 97624-0490 |
| Practice Telephone | 5417832438 |
| Practice Fax Number | 5417833554 |
| Mailing Telephone | 5417832438 |
| Mailing Fax Number | 5417833554 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2019-10-28 |
| Authorized Official Name | TIMOTHY G. LANGFORD (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 5417833551 |
| Authorized Official Credential | PHARM D, BCPS, C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 115761 | 05 | |
| PK | 2078297 | 01 |
| Other Name | Type Code |
|---|---|
| KLAMATH TRIBAL HEALTH PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578864641 | Klamath Tribal Health & Family Services | Substance Abuse Rehabilitation Facility | 121 Iowa St., Klamath Falls, OR 97601 | 2010-11-05 |
| 1629078274 | Klamath Tribal Health & Family Services | Clinic/Center | 330 Chiloquin Blvd, Chiloquin, OR 97624 | 2005-07-26 |
| Street Address |
330 S CHILOQUIN BLVD |
| City | CHILOQUIN |
| State | OR |
| Zip Code | 97624-6747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538156351 | Elizabeth Burton Matuk | Nurse Practitioner | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2005-10-06 |
| 1972148427 | Mason Zhang | Pharmacist | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2019-11-07 |
| 1881169464 | Sarah O'brien | Nurse Practitioner | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2018-10-10 |
| 1245747476 | Bita Vaghari | Dentist | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2018-01-09 |
| 1114448529 | Benjamin Russel Stuart | Registered Nurse | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2017-07-06 |
| 1356712392 | Daniel Wayne Conant | Pharmacist | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2015-10-16 |
| 1215201223 | Jay P Flesch | Pharmacist | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2012-03-08 |
| 1215218292 | Anjanette Michelle Devine | Nurse Practitioner | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2011-09-02 |
| 1700952736 | Thuc Xuan Ngo | Dentist | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2006-11-28 |
| 1285610642 | Timothy George Langford | Pharmacist | 330 S Chiloquin Blvd, Chiloquin, OR 97624-6747 | 2005-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588805832 | Klamath Tribal Health and Family Services | Clinic/Center | 330 Chiloquin Boulevard, Chiloquin, OR 97624 | 2009-03-17 |
| 1922250364 | Melissa Sample | Registered Nurse | 103 Waso, Chiloquin, OR 97624 | 2008-10-16 |
| 1225291503 | Klamath Health Partnership Inc | Clinic/Center | 103 Wasco Ave, Chiloquin, OR 97624 | 2008-07-07 |
| 1598834822 | Edward Stuart Walker | Dentist | 330 Chiloquin, Chiloquin, OR 97624 | 2006-11-08 |
| 1295728624 | Jamie D. Rich | Internal Medicine | 330 Chiloquin Blvd., Chiloquin, OR 97624 | 2005-08-31 |
| 1629078274 | Klamath Tribal Health & Family Services | Clinic/Center | 330 Chiloquin Blvd, Chiloquin, OR 97624 | 2005-07-26 |
| 1114296720 | Marcy J. Ayres | Dietitian, Registered | 330 Chiloquin Blvd., Chiloquin, OR 97624 | 2011-12-28 |
| 1427351576 | Laura A. Snyder | Dentist | 330 Chiloquin Blvd., Chiloquin, OR 97624 | 2010-12-13 |
| 1225260946 | Qiang Yin | Transplant Surgery | 330 Chiloquin Blvd., Chiloquin, OR 97624 | 2009-08-13 |
| 1861412884 | Kathy Kiryang Bak | Family Medicine | 330 Chiloquin Blvd, Chiloquin, OR 97624 | 2006-07-20 |
| Find all providers in zip 97624 | ||||
| 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 |
|---|---|---|---|---|
| 1376672352 | Warm Springs Health and Wellness Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1270 Kot-num Rd, Warm Springs, OR 97761 | 2007-03-05 |
| 1902933443 | Warm Springs Health and Wellness Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1270 Kotnum Rd, Warm Springs, OR 97761 | 2007-02-28 |
| 1861556920 | Chemawa Indian Health Center Dhhs Ihs Western Oregon Serv Unit | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 3750 Chemawa Rd Ne, Chemawa Indian Health Center Western Oregon Service Uni, Salem, OR 97305-1119 | 2006-12-21 |
| 1285706721 | Yellowhawk Tribal Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 46314 Timine Way, Pendleton, OR 97801-9417 | 2006-11-13 |
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| 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.