KICKAPOO NATION HEALTH CENTER


Address: 1117 Goldfinch Road, Horton, KS 66439
Phone: 7854862154

KICKAPOO NATION HEALTH CENTER (NPI# 1801058748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801058748
Entity Type Organization
Organization Name KICKAPOO NATION HEALTH CENTER
Other Organization Name KICKAPOO NATION HEALTH CENTER
Practice Address 1117 Goldfinch Road
Horton
KS 66439
Practice Telephone 7854862154
Practice Fax Number 7854862158
Mailing Telephone 7854862154
Mailing Fax Number 7854862158
Enumeration Date 2008-07-01
Last Update Date 2012-10-26
Authorized Official Name DR. PAUL KELLY AUSTIN (PHARMICIST)
Authorized Official Telephone 7854862154
Authorized Official Credential PHARM D
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
KS 200438190A 05
NABP 1718052 01

Other Provider/Organization Names

Other Name Type Code
KICKAPOO NATION HEALTH CENTER Doing Business As Name - Organization

Office Location

Street Address 1117 GOLDFINCH ROAD
City HORTON
State KS
Zip Code 66439

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1447434212 Cah Acquisition Company 3 LLC Medicare Defined Swing Bed Unit 240 W 18th St, Horton, KS 66439 2007-12-28
1952585721 Cah Acquisition Company 3 LLC Family Medicine 240 W 18th St, Horton, KS 66439 2007-12-28
1598949364 Cah Acquisition Company 3 LLC Clinic/Center 1903 Euclid Ave, Horton, KS 66439 2007-12-28
1053467910 Roger Dean Allen Technician 1665 4th Ave W, Horton, KS 66439-1114 2007-01-25
1093754699 Bradley G Farr Chiropractor 120 W 18th St, Horton, KS 66439-1211 2006-06-06
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Taxonomy Information

Taxonomy Code 332800000X
Grouping Suppliers
Classification Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1275683369 White Cloud Ihs Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 3313 Thrasher Rd, White Cloud, KS 66094-4028 2007-01-11
1194288480 White Cloud Health Center, LLC Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 3349b Thrasher Rd, White Cloud, KS 66094-4005 2019-04-12
1326198581 Haskell Ihs Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 2415 Massachusetts St, Lawrence, KS 66046-4827 2007-01-11
1952323958 Prairie Band Potawatomi Nation Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 11400 158th Rd, Mayetta, KS 66509-8866 2006-07-25

Competitor

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City HORTON
Zip Code 66439

Improve Information

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Dataset Information

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.

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