National Provider Identifier Database

MENOMINEE INDIAN TRIBE OF WISCONSIN
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

MENOMINEE INDIAN TRIBE OF WISCONSIN
W3275 WOLF RIVER ROAD
KESHENA, WI54135
Phone: 715-799-3361
Fax: 715-799-3099
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X

* Indicates primary specialty

NPI Profile & details for MENOMINEE INDIAN TRIBE OF WISCONSIN

NPI Number 1972545010
Legal business name
LBN
MENOMINEE INDIAN TRIBE OF WISCONSIN
Authorized official JERRY WAUKAU - (HEALTH ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 06/12/2006
Last updated 03/07/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • WI License #: 7848-042
  • WI Medicaid: 32955700
  • Other: 5118446 NAPB #

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for MENOMINEE INDIAN TRIBE OF WISCONSIN

There are currently no reviews for MENOMINEE INDIAN TRIBE OF WISCONSIN


NPIdb - Home
v2.201