Mashantucket Pequot Tribal
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Mashantucket, Connecticut
1720024524- Practice location
- 1 Annie George Drive, Bldg 1, Mashantucket, CT 06338-3801
- Phone
- 860-396-6435
- Fax
- 800-779-6329
- Last updated
- April 16, 2025
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 1720024524. The current practice location address for Mashantucket Pequot Tribal is 1 Annie George Drive, Bldg 1, Mashantucket, CT 06338-3801 and can be reached out via phone at 860-396-6435 and via fax at 800-779-6329.
Provider Profile Details
- NPI Number
- 1720024524
- Provider Name
- Mashantucket Pequot Tribal
- Provider Entity Type
- Organization
- Address
- 1 Annie George Drive, Bldg 1, Mashantucket, CT 06338-3801
- Phone Number
- 860-396-6435
- Fax Number
- 800-779-6329
- Primary Taxonomy
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · 332800000X
- Organization Subpart
- Yes
- Parent Organization
- Mashantucket Pequot Tribal
- Authorized Official
- Dr. John Grossomanides, PHARMD, RPH · Director Of Pharmacy Services · 860-396-6435
- Other Names
- Pequot Health Care (Doing Business As)
- Provider Enumeration Date
- June 21, 2006
- Last Update Date
- April 16, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1 Annie George Drive
Bldg 1
Mashantucket, CT 06338-3801 - City
- Mashantucket
- State
- Connecticut
- Zip
- 06338-3801
- Phone Number
- 860-396-6435
- Fax Number
- 800-779-6329
Provider Business Mailing Address Details
- Address
- 1 Annie George Drive
Bldg 1
Mashantucket, CT 06338-3801 - City
- Mashantucket
- State
- CT
- Zip
- 06338-3801
- Phone Number
- 860-396-6435
- Fax Number
- 860-396-6212
License Information
- Taxonomy (1)
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · 332800000X · Primary
- Taxonomy (2)
- Pharmacy · 333600000X
- Taxonomy (3)
- Pharmacy, Mail Order Pharmacy · 3336M0002X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mashantucket Pequot Tribal?
The NPI number of Mashantucket Pequot Tribal is 1720024524. It was assigned on June 21, 2006 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 Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (code 332800000X).
Where does Mashantucket Pequot Tribal practice?
The practice location is 1 Annie George Drive, Bldg 1, Mashantucket, CT 06338-3801. The office can be reached at 860-396-6435 (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 1720024524 directly on the NPPES registry website.