CMS-1500 Box 24J / 33a • NPI
1790795888
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
111 BEVER GRADE, NIMIIPUU HEALTH, LAPWAI, ID, 83540-0367
✓ 9-Digit EDI 837 ZIP+4 (83540-0367)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1790795888 (NEZ PERCE TRIBAL HEALTH AUTHORITY) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1790795888 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | NEZ PERCE TRIBAL HEALTH AUTHORITY |
| 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 | 111 BEVER GRADE, NIMIIPUU HEALTH, LAPWAI, ID, 83540-0367 |
| Practice Telephone / Fax | Tel: (208) 843-2271 | Fax: (208) 621-4995 |
| Administrative Mailing Address | PO BOX 367, LAPWAI, ID, 83540-0367 |
| Enumeration & Last Sync | Enumerated: 2006-08-09 | CMS Record Updated: 2022-07-22 |
| Authorized Official | R. HARTWIG (Medical Director) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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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"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (NEZ PERCE TRIBAL HEALTH AUTHORITY)
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
- 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 |
|---|---|
261QF0400X — Clinic/Center, Federally Qualified Health Center (FQHC)Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: ID | License: Verified | Primary: Secondary |
332800000X — Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyPlain 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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