ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC. — NPI 1831294024 (Licensed & Credentialed Suppliers — Indian Health Service — Tribal — Urban Indian Health (I — T

CMS-1500 Box 24J / 33a • NPI

1831294024

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

2029 GORDON COOPER DR, SHAWNEE, OK, 74801-9005

✓ 9-Digit EDI 837 ZIP+4 (74801-9005)

Practice Phone & Referral Fax

(405) 878-5859

Fax: (405) 669-3099

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1831294024 (ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.) 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	`1831294024` (NPI-2 Organization / Facility)
Provider / Legal Name	ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.
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	2029 GORDON COOPER DR, SHAWNEE, OK, 74801-9005
Practice Telephone / Fax	Tel: (405) 878-5859 \| Fax: (405) 669-3099
Administrative Mailing Address	15951 LITTLE AXE DR, NORMAN, OK, 73026-9088
Enumeration & Last Sync	Enumerated: 2006-09-13 \| CMS Record Updated: 2026-08-12
Authorized Official	MARTY LOFGREN (Executive/ Medical Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2029 GORDON COOPER DR, SHAWNEE, OK, 74801-9005

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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 (ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.)

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: OK \| License: `10-4263` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC. (NPI #1831294024)