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Mashantucket Pequot Tribal
Managed Care Organization Pharmacy in Mashantucket, Connecticut
NPI 1003036435

Mashantucket Pequot Tribal is a Managed Care Organization Pharmacy based in Mashantucket, CT and is specialized in Managed Care Organization Pharmacy. Mashantucket Pequot Tribal practices in Mashantucket, CT. The NPI Number for Mashantucket Pequot Tribal is 1003036435 and holds a License No. ISH285960015 (Connecticut).

The current practice location address for Mashantucket Pequot Tribal is 1 Annie George Dr, Mashantucket, CT and can be reached out via phone at 860-396-6438 and via fax at 866-396-6212.

Location: 1 Annie George Dr, Mashantucket, CT, 06338-3801
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1003036435
Provider Name
Mashantucket Pequot Tribal
Credential
Provider Entity Type
Organization
Address
1 Annie George Dr, Mashantucket, CT, 06338-3801
Phone Number
860-396-6438
Fax Number
866-396-6212
Provider Enumeration Date
04/26/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004129210 05 CT
0718619 01 NCPDP PROVIDER IDENTIFICATION NUMBER
institution
Provider Business Practice Location Address Details
Address
1 Annie George Dr
City
Mashantucket
State
Connecticut
Zip
06338-3801
Phone Number
860-396-6438
Fax Number
866-396-6212
person
Provider Business Mailing Address Details
Address
1 Annie George Dr
City
Mashantucket
State
Connecticut
Zip
06338-3801
Phone Number
860-396-6438
Fax Number
866-396-6212
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
()
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 Health Care Improvement Act, 25 U.S.C. 1603.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
()
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Pharmacy
Speciality
Mail Order Pharmacy
Taxonomy
3336M0002X
License No.
()
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 caregivers (sometimes independent of the dispensing process) through telephone or email contact and provide other professional services associated with pharmaceutical care appropriate to the setting. Mail order pharmacies are licensed as a Mail Order Pharmacy in the state where they are located and may also be licensed or registered as nonresident pharmacies in other states.
person
Provider's Taxonomy Details 4
Type
Suppliers
Classification
Pharmacy
Speciality
Managed Care Organization Pharmacy
Taxonomy
3336M0003X
License No.
ISH285960015 (Connecticut)
Definition
A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's covered members only.
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Similar Doctors in Mashantucket, Connecticut:

institution
Mashantucket Pequot Tribal
NPI 1720024524
Managed Care Organization Pharmacy
1 Annie George Dr,
MASHANTUCKET, CT
06338-3801
860-396-6438
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