| Organization Name: | INDIAN HEALTH SERVICE-WEWOKA |
| NPI Number: | 1225483522 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRACY FARRILL (CHIEF PHARMACIST) |
| Mailing Address: | Jct Hwys 56 & 270 Wewoka |
| State: | OK US |
| Postal Code: | 74884 |
| Phone Number: | 4052577361 |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2016 |
| NPI Last Update Date: | 04/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP0904X |
| License Number: | VA0202205912 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Public Health, Federal |
| Taxonomy Definition: | |