National Provider Identifier Database

STOCKBRIDGE MUNSEE COMMUNITY
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

STOCKBRIDGE MUNSEE COMMUNITY
W12802 COUNTY ROAD A
BOWLER, WI54416-0086
Phone: 715-793-4144
Fax: 715-793-4120
Website:
Specialty Taxonomy Code
* Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

* Indicates primary specialty

NPI Profile & details for STOCKBRIDGE MUNSEE COMMUNITY

NPI Number 1942331467
Legal business name
LBN
STOCKBRIDGE MUNSEE COMMUNITY
Authorized official ROBERT CHICKS - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 03/08/2007
Last updated 12/04/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • WI Medicaid: 33021000
  • WI Other: 5118799 NCPDC-PHARMACY

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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