Provider Demographics
NPI:1972630234
Name:SANTEE CLINIC HEALTH CENTER PHARMACY
Entity Type:Organization
Organization Name:SANTEE CLINIC HEALTH CENTER PHARMACY
Other - Org Name:SANTEE CLINIC PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMFALK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D
Authorized Official - Phone:402-857-2901
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:SANTEE HEALTH CENTER - ATTN PHARMACY
Mailing Address - City:NIOBRARA
Mailing Address - State:NE
Mailing Address - Zip Code:68760
Mailing Address - Country:US
Mailing Address - Phone:402-857-2901
Mailing Address - Fax:402-857-2911
Practice Address - Street 1:110 S. VISITING EAGLE STREET
Practice Address - Street 2:
Practice Address - City:NIOBRARA
Practice Address - State:NE
Practice Address - Zip Code:68760
Practice Address - Country:US
Practice Address - Phone:402-857-2901
Practice Address - Fax:402-857-2911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2815477OtherNCPDP NUMBER
BS4621430OtherPHARMACY DEA NUMBER