Keweenaw Bay Indian Community D.a.Lapointe Health Facility Pharmacy
Organization Active NPI Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Baraga, MI
NPI 1114217833 · NPPES record last updated Dec 20, 2017
Key facts
- NPI
- 1114217833
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
- Legal business name
- KEWEENAW BAY INDIAN COMMUNITY D.A.LAPOINTE HEALTH FACILITY PHARMACY
- Practice address
- 102 Superior Ave
Baraga, MI 49908-9673 - Phone
- (906) 353-4555
- Fax
- (906) 353-8066
- NPI assigned
- Apr 14, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- KEWEENAW BAY INDIAN COMMUNITY D,A.LAPOINTE HEALTH FACILITY
Authorized official
- Name
- Ms. Kathy Mayo
- Title
- Interim Health Administrator
- Phone
- (906) 353-8700
Corporate family (same tax ID) 3
Practitioners 2
-
Shirley R Courey, NP
National Provider Directory
- Tax ID family
- Keweenaw Bay Indian Com
- Part of
- Keweenaw Bay Indian Com
Locations
102 S Superior Ave
Baraga, MI 49908
Phone (906) 353-4542
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | |||
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | Yes |
Addresses
Primary practice location
102 Superior Ave
Baraga, MI 49908-9673
Mailing address
102 Superior Ave
Baraga, MI 49908-9673
Phone (906) 353-4555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336232289 | Medicaid | MI |
Other providers in Baraga, MI
- Sara Jamison
- Richard Brent Johnson
- Thomas Kallal
- Ruth L Keller
- Keweenaw Bay Indian Community
- Keweenaw Bay Indian Community Mihp Program
- Kirk R. Schott, O.D., P.C.
- Toby Leroy Klassen
- Ann Marie Lanala
- John Matthew Lassila
All providers in Baraga, MI · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.