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Contact Information

RED CLIFF BAND OF :AKE SUPERIOR
36745 AIKEN RD
BAYFIELD, WI54814-4579
 Phone: 715-779-3157
 Fax: 715-779-3501
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

332800000X 87 All Other Suppliers
 

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for RED CLIFF BAND OF :AKE SUPERIOR

NPI Number 1275606808
LBN Legal business name RED CLIFF BAND OF :AKE SUPERIOR
Authorized official RICHARD PETERSON - (TRIBAL CHAIRMAN)
Entity Organization
Organization subpart 1 No
Enumeration date 11/15/2006
Last updated 07/19/2018 - About 8 years ago
Identifiers
WI Medicaid 32956200
Other 2108718 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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