Organization · Type 2 NPI

Ponca Tribe of Nebraska

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Omaha, NE

NPI number 1760778385 Active

Practice location

2602 J St, Fred Leroy Health And Wellness Center Pharmacy
Omaha, NE 68107-1643

Fax (402) 733-3487

Specialties and licenses

Taxonomy	Code	License
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Primary	332800000X	2884 (NE)

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.

34 other providers at this address

Other indian health service/tribal/urban indian health (i/t/u) pharmacy providers in Omaha

Ponca Tribe of NebraskaIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Omaha, NE NPI 1356673040

See all in Omaha →

NPI record

NPI: 1760778385
Entity type: Organization (Type 2)
Issued: Jun 22, 2011
Last updated: Jun 22, 2011
Status: Active
Subpart: Yes of Ponca Tribe of Nebraska

Other names

<unavail>
Fred Leroy Health and Wellness Center Pharmacy · doing business as

Authorized official

Mr. Donald Lee, MS
Chief Executive Officer
(402) 734-5275

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1760778385

Ponca Tribe of Nebraska's National Provider Identifier is 1760778385, issued on Jun 22, 2011. The primary taxonomy on file is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (332800000X), and the practice location is in Omaha, NE. The record was last updated on Jun 22, 2011.