OrganizationActive
Prairie Band Potawatomi Nation
NPI 1952323958 · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Mayetta, KS
Provider details
- NPI number
- 1952323958
- Entity type
- Organization
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
- Parent organization
- Prairie Band Potawatomi Nation
- Organization subpart
- Yes
- Authorized official
- Mike Carpenter, Chief Pharmacist(785) 966-8266
- License
- 2-2546 (KS)
Specialties & taxonomies
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyPrimary332800000XLicense 2-2546 (KS)
Suppliers
Practice location
11400 158th Rd
Mayetta, KS 66509-8866
Phone: (866) 727-6330
Fax: (785) 966-8396
Approximate (ZIP-level) locationGet directions
Mailing address
11400 158th Rd
Mayetta, KS 66509-0249
Registry dates
- Enumerated
- 2006-07-25
- Last updated
- 2018-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.