Mashantucket Pequot Tribal in Mashantucket - Pharmacy
Mashantucket Pequot Tribal - NPI 1003036435
Mashantucket Pequot Tribal is a Pharmacy in Mashantucket, Connecticut. Mashantucket Pequot Tribal practices all healthcare services and medical treatments related to 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 |
|---|---|
| Provider Enumeration Date | 2007-04-26 |
| Last Updated Date | 2011-04-01 |
Provider Mailing Address Detail
| Address | 1 Annie George Dr |
|---|---|
| City | Mashantucket |
| State | Connecticut (CT) |
| Post Code | 63383801 |
| Phone Number | 8603966438 |
| Fax Number | 8663966212 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacy |
|---|---|
| Taxonomy | 333600000X |
|
Definition: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense presc |
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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 Pharmacy, and the corresponding taxonomy code that categorizes this area of expertise is 333600000X.
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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