PRAIRIE BAND POTAWATOMI NATION
Medical Equipment Supplier Yellow Pages
Mayetta, Kansas
Provider NPI: 1952323958
Organization Information:Organization Name: PRAIRIE BAND POTAWATOMI NATION
Practice Location:
11400 158TH RD MAYETTA, KS 66509 US
Tel: 866-727-6330 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
11400 158TH RD MAYETTA, KS 66509 US
Tel: 866-727-6330 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 332800000X | Suppliers Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | KS | 2-2546 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
PK | 2027266 | 01 | |
200259300B | KS | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin