Mashantucket Pequot Tribal
Mashantucket Pequot Tribal is an Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Mashantucket, Connecticut. Licensed in Connecticut. Registered with an NPI since 2007.
- Licensed in
- CT
- In the registry since
- 2007
- Specialties on file
- 4
Practice location Address checks out
1 Annie George DrMashantucket, CT 06338-3801
Phone: (860) 396-6438
Fax: (866) 396-6212
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (primary) | Taxonomy 332800000X · Licence ISH285960015 (CT) |
|---|---|
| Pharmacy | Taxonomy 333600000X |
| Mail Order Pharmacy | Taxonomy 3336M0002X |
| Managed Care Organization Pharmacy | Taxonomy 3336M0003X |
Record details
| NPI number | 1003036435 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Edward Moldenhauer — Director Of Pharmacy Operation · (860) 396-2058 |
| Other names | Pequot Health Care |
| NPI enumerated | April 26, 2007 |
| Last updated in NPPES | April 1, 2011 |
| Mailing address | 1 Annie George Dr, Po Box 3559, Mashantucket, CT 06338-3801 |
Other providers in Mashantucket
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Mashantucket Pequot Tribal
1 Annie George Dr Bldg 1, Mashantucket, CT 06338-3801 · (860) 396-6435