Organization · Type 2 NPI

Bad River Band of Lake Superior Tribe of Chippewa Indians Wis.

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Ashland, WI

NPI number 1780702829 Active

Practice location

53585 Nokomis Road
Ashland, WI 54806-4272

Fax (715) 685-8810

Specialties and licenses

Taxonomy	Code	License
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Primary	332800000X	None 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.

4 other providers at this address

NPI record

NPI: 1780702829
Entity type: Organization (Type 2)
Issued: Mar 27, 2007
Last updated: Jun 3, 2024
Status: Active
Subpart: Yes of Bad River Band of Lake Superior Tribe of Chippewa Indians Wis.

Other names

<unavail>
Bad River Clinic Pharmacy · doing business as
Bad River Clinic Pharmacy · doing business as

Authorized official

June Louise Williams
Billing/prc Manager
(715) 682-7133

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1780702829

Bad River Band of Lake Superior Tribe of Chippewa Indians Wis.'s National Provider Identifier is 1780702829, issued on Mar 27, 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 Ashland, WI. The record was last updated on Jun 3, 2024.