National Provider Identifier Database

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

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.


Contact Information

PASSAMAQUODDY TRIBAL COUNCIL
11 BACK RD
PLEASANT POINT, ME04667-4119
Phone: 207-853-0644
Fax: 207-853-6230
Website:
Specialty Taxonomy Code
* Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

* Indicates primary specialty

NPI Profile & details for PASSAMAQUODDY TRIBAL COUNCIL

NPI Number 1366526188
Legal business name
LBN
PASSAMAQUODDY TRIBAL COUNCIL
Authorized official KIRK ALTVATER - (HEALTH CENTER DIRECTOR)
Entity Organization
Organization subpart Yes
Enumeration date 10/25/2006
Last updated 04/08/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • ME License #: PH50000192
  • ME Medicaid: 107300100

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.

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