Mashantucket Pequot Tribal in Mashantucket - Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
Mashantucket Pequot Tribal - NPI 1720024524
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 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 | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy |
|---|---|
| Taxonomy | 332800000X |
|
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 | -- | |
| 2000351 | PK |
Post Comment/ Review Below
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 Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy, and the corresponding taxonomy code is 332800000X.
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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