MOHEGAN TRIBE OF INDIANS OF CONNECTICUT; NPI #1467442863

Contact Information

MOHEGAN TRIBE OF INDIANS OF CONNECTICUT

13 CROW HILL RD
UNCASVILLE, CT 06382-1118

Phone: 860-862-6110
Fax: 860-862-6140
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulance	341600000X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for MOHEGAN TRIBE OF INDIANS OF CONNECTICUT

NPI Number 1467442863

LBN Legal business name MOHEGAN TRIBE OF INDIANS OF CONNECTICUT

Authorized official MARY GENTILE - (AUTHORIZED AGENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/26/2005

Last updated 06/19/2019 - About 7 years ago

Identifiers

	License #	C086P1
CT	Medicaid	004185428
	Other	590012782	RAILROAD MEDICARE

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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