EAGLE BUTTE IHS HOSPITAL PHARMACY — NPI 1770610842 (Licensed & Credentialed Suppliers — Indian Health Service — Tribal — Urban Indian Health (I — T

CMS-1500 Box 24J / 33a • NPI

1770610842

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

332800000X (CMS A9[12])

Licensed & Credentialed Suppliers — Indian Health Service — Tribal — Urban Indian Health (I — T — U) Pharmacy

Box 32 Service Location & ZIP+4

317 MAIN ST, EAGLE BUTTE, SD, 57625

Official NPPES Practice Location

Practice Phone & Referral Fax

(605) 964-0654

Fax: (605) 964-1110

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1770610842 (EAGLE BUTTE IHS HOSPITAL PHARMACY) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1770610842` (NPI-2 Organization / Facility)
Provider / Legal Name	EAGLE BUTTE IHS HOSPITAL PHARMACY
Plain-English Specialty	Licensed & Credentialed Suppliers — Indian Health Service — Tribal — Urban Indian Health (I — T — U) Pharmacy NUCC Code: `332800000X` (Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	317 MAIN ST, EAGLE BUTTE, SD, 57625
Practice Telephone / Fax	Tel: (605) 964-0654 \| Fax: (605) 964-1110
Administrative Mailing Address	3109 SOLUTIONS CTR, CHICAGO, IL, 60677-3001
Enumeration & Last Sync	Enumerated: 2007-02-27 \| CMS Record Updated: 2013-03-07
Authorized Official	JAMES CUMMINGS (Pharmacy Program Specialist)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

317 MAIN ST, EAGLE BUTTE, SD, 57625

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Plain-English Taxonomy & CMS Crosswalk (332800000X)

What Does Taxonomy Code 332800000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 332800000X translates to:
"Licensed & Credentialed Suppliers — Indian Health Service — Tribal — Urban Indian Health (I — T — U) Pharmacy"

CMS-1500 Medicare Specialty Crosswalk: CMS Code A9[12] (Indian Health Service facility[13])
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (EAGLE BUTTE IHS HOSPITAL PHARMACY)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`332800000X` — Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Plain English: Licensed & Credentialed Suppliers — Indian Health Service — Tribal — Urban Indian Health (I — T — U) Pharmacy	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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EAGLE BUTTE IHS HOSPITAL PHARMACY (NPI #1770610842)