Mashantucket Pequot Tribal in Mashantucket - Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
Mashantucket Pequot Tribal - NPI 1003036435
Mashantucket Pequot Tribal is a Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy in Mashantucket, Connecticut. Mashantucket Pequot Tribal practices all healthcare services and medical treatments related to Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy. The NPI Number for Mashantucket Pequot Tribal is 1003036435. The last update date is 2011-04-01.
Mashantucket Pequot Tribal's current location address is 1 Annie George Dr, Mashantucket, Connecticut. You can contact this provider via phone number 8603966438 and fax number 8663966212. The mailing address for Mashantucket Pequot Tribal is 1 Annie George Dr, Mashantucket, Connecticut. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Mashantucket Pequot Tribal |
---|---|
Address | 1 Annie George Dr, Mashantucket, Connecticut |
Phone Number | 8603966438 |
Fax Number | 8663966212 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | DIRECTOR O |
---|---|
Authorized Official Name | Moldenhauer Edward |
Credentials | MS BS PHAR |
Telephone Number | 8603962058 |
NPI Number Detail
NPI Number | 1003036435 |
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Provider Enumeration Date | 2007-04-26 |
Last Updated Date | 2011-04-01 |
Provider Mailing Address Detail
Address | 1 Annie George Dr |
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City | Mashantucket |
State | Connecticut (CT) |
Post Code | 63383801 |
Phone Number | 8603966438 |
Fax Number | 8663966212 |
Provider's Primary Taxonomy Detail
Speciality | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy |
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Taxonomy | 332800000X |
Licence No | ISH285960015 |
Definition: An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
4129210 | CT | -- | |
718619 | NCPDP PROVIDER IDENTIFICATION |
Post Comment/ Review Below
What is the unique identifier code issued to Mashantucket Pequot Tribal by the Centers for Medicare & Medicaid Services (CMS)?
The Mashantucket Pequot Tribal has been assigned the NPI (National Provider Identifier) 1003036435. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Mashantucket Pequot Tribal's physical address?
The Mashantucket Pequot Tribal is physically located at 1 Annie George Dr, in the city of Mashantucket, CT, with the postal code 63383801.
What is the area of specialization for Mashantucket Pequot Tribal, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Mashantucket Pequot Tribal is Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy, and the corresponding taxonomy code that categorizes this area of expertise is 332800000X.
On what date did the Mashantucket Pequot Tribal receive its 1003036435 assignment from the Centers for Medicare & Medicaid Services?
The Mashantucket Pequot Tribal was assigned its 1003036435 by the Centers for Medicare & Medicaid Services on 2007-04-26.
As of what date was the information pertaining to Mashantucket Pequot Tribal, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Mashantucket Pequot Tribal, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2011-04-01.
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