Active NPIOrganization

Mashantucket Pequot Tribal

Pharmacy, Mail Order Pharmacy in Mashantucket, Connecticut

NPI Number1578886461
Practice location
1 Annie George Dr, Bldg 1, Mashantucket, CT 06338-3801
Fax
800-779-6329
Last updated
April 1, 2011

Mashantucket Pequot Tribal is a healthcare organization based in Mashantucket, CT. Mashantucket Pequot Tribal practices in Mashantucket, CT. The NPI Number for Mashantucket Pequot Tribal is 1578886461 and holds a License No. 285960015 (CT). The current practice location address for Mashantucket Pequot Tribal is 1 Annie George Dr, Bldg 1, Mashantucket, CT 06338-3801 and can be reached out via phone at 860-396-6438 and via fax at 800-779-6329.

Provider Profile Details

NPI Number
1578886461
Provider Name
Mashantucket Pequot Tribal
Provider Entity Type
Organization
Address
1 Annie George Dr, Bldg 1, Mashantucket, CT 06338-3801
Phone Number
860-396-6438
Fax Number
800-779-6329
Primary Taxonomy
Pharmacy, Mail Order Pharmacy · 3336M0002X
Organization Subpart
No
Authorized Official
Edward Moldenhauer · Director Of Pharmacy Operation · 860-396-2058
Other Names
Pequot Health Care (Doing Business As)
Provider Enumeration Date
March 5, 2010
Last Update Date
April 1, 2011
NPI Status
Active

Provider Business Practice Location Address Details

Address
1 Annie George Dr
Bldg 1
Mashantucket, CT 06338-3801
Zip
06338-3801
Phone Number
860-396-6438
Fax Number
800-779-6329
Mashantucket, CT 06338Get directions →

Provider Business Mailing Address Details

Address
1 Annie George Dr
Po Box 3559
Mashantucket, CT 06338-3801
City
Mashantucket
State
CT
Zip
06338-3801
Phone Number
860-396-2058
Fax Number
860-396-6212

License Information

License Number
285960015
License State
CT
Taxonomy
Pharmacy, Mail Order Pharmacy · 3336M0002X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

Other Pharmacy, Mail Order Pharmacy providers near Mashantucket, CT

View all Pharmacy, Mail Order Pharmacy providers in Mashantucket →

Frequently Asked Questions

What is the NPI number of Mashantucket Pequot Tribal?

The NPI number of Mashantucket Pequot Tribal is 1578886461. It was assigned on March 5, 2010 and is currently active in the NPPES registry.

What is the specialty of Mashantucket Pequot Tribal?

Mashantucket Pequot Tribal is registered under the primary taxonomy Pharmacy, Mail Order Pharmacy (code 3336M0002X), licensed in CT under license number 285960015.

Where does Mashantucket Pequot Tribal practice?

The practice location is 1 Annie George Dr, Bldg 1, Mashantucket, CT 06338-3801. The office can be reached at 860-396-6438 (phone) or 800-779-6329 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1578886461 directly on the NPPES registry website.

Browse related providers