Organization · Type 2 NPI

Mashantucket Pequot Tribal

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Mashantucket, CT

NPI number 1003036435 Active

Practice location

1 Annie George Dr
Mashantucket, CT 06338-3801

Call (860) 396-6438 Map

Fax (866) 396-6212

Specialties and licenses

TaxonomyCodeLicense
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Primary 332800000XISH285960015 (CT)
Pharmacy 333600000XNone listed
Mail Order Pharmacy 3336M0002XNone listed
Managed Care Organization Pharmacy 3336M0003XNone listed

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy: 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 Health Care Improvement Act, 25 U.S.C. 1603.

8 other providers at this address

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About NPI 1003036435

Mashantucket Pequot Tribal's National Provider Identifier is 1003036435, issued on Apr 26, 2007. The primary taxonomy on file is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (332800000X), and the practice location is in Mashantucket, CT. The record was last updated on Apr 1, 2011.