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).
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 |
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 |
---|---|---|---|
KS | 200438190A | 05 | |
NABP | 1718052 | 01 |
Other Name | Type Code |
---|---|
KICKAPOO NATION HEALTH CENTER | Doing Business As Name - Organization |
Street Address |
1117 GOLDFINCH ROAD |
City | HORTON |
State | KS |
Zip Code | 66439 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396929162 | Cah Acquisition Company 3 LLC | Ambulance | 240 W 18th Street, Horton, KS 66439 | 2007-12-28 |
1346396058 | Mission Village Living Center, Inc | Assisted Living Facility | 1890 Euclid Avenue, Horton, KS 66439 | 2007-01-26 |
1881794725 | Horton Family Medicine | Family Medicine | 1890 Euclid Ave, Suite 4, Horton, KS 66439 | 2006-09-22 |
1710161583 | Cah Acquisition Company 3 LLC | Pharmacy | 1903 Euclid Ave, Horton, KS 66439 | 2007-12-28 |
1518141373 | Cah Acquisition Company 3 LLC | General Acute Care Hospital | 240 W 18th St, Horton, KS 66439 | 2007-12-28 |
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 |
Find all providers in zip 66439 |
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 |
---|---|---|---|---|
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 |
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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.