Mashantucket Pequot Tribal in Mashantucket - Mail Order Pharmacy

Mashantucket Pequot Tribal - NPI 1720024524

Mashantucket Pequot Tribal is a Mail Order Pharmacy in Mashantucket, Connecticut. Mashantucket Pequot Tribal practices all healthcare services and medical treatments related to Mail Order Pharmacy. The NPI Number for Mashantucket Pequot Tribal is 1720024524. The last update date is 2016-10-06.

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 8007796329. 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 8007796329
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 1720024524
Provider Enumeration Date 2006-06-21
Last Updated Date 2016-10-06

Provider Mailing Address Detail

Address 1 Annie George Dr
City Mashantucket
State Connecticut (CT)
Post Code 63383801
Phone Number 8603966438
Fax Number 8007796329

Provider's Primary Taxonomy Detail

Speciality Mail Order Pharmacy
Taxonomy 3336M0002X
Definition:
A pharmacy where pharmacists compound or dispense prescriptions or other medications in accordance with federal and state law, using common carriers to deliver the medications to patient or their caregivers. Mail order pharmacies counsel patients and

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
4129210 CT --
2000351 PK

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FAQs about Mashantucket Pequot Tribal

What is the unique identifier code issued to Mashantucket Pequot Tribal by the Centers for Medicare & Medicaid Services?

The Mashantucket Pequot Tribal has been assigned the NPI (National Provider Identifier) 1720024524. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).

Could you share the physical location details of Mashantucket Pequot Tribal?

The Mashantucket Pequot Tribal is situated at 1 Annie George Dr, in the city of Mashantucket, state of CT, with the zip code 63383801.

What is the Mashantucket Pequot Tribal's specialty and taxonomy code?

The Mashantucket Pequot Tribal's specialty is Mail Order Pharmacy, and the corresponding taxonomy code is 3336M0002X.

On what date did the Centers for Medicare & Medicaid Services assign the 1720024524 to Mashantucket Pequot Tribal?

The Centers for Medicare & Medicaid Services assigned the 1720024524 to Mashantucket Pequot Tribal on 2006-06-21.

As of what date was the information regarding Mashantucket Pequot Tribal, such as address, specialty, and other details, last verified and confirmed to be up-to-date?

The information related to Mashantucket Pequot Tribal, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2016-10-06.

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