NPIMap

Organization Active NPI

Red Cliff Band of :Ake Superior

Doing business as Red Cliff Comm Health Center Phy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Bayfield, WI
National Provider Identifier
1275606808
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
RED CLIFF BAND OF :AKE SUPERIOR
Doing business as
Red Cliff Comm Health Center Phy
Practice address
36745 Aiken Rd
Bayfield, WI 54814-4579
Phone
(715) 779-3157
Fax
(715) 779-3501
NPI assigned
Nov 15, 2006
Last updated
Jul 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard Peterson
Title
Tribal Chairman
Phone
(715) 779-3700

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

36745 Aiken Rd
Bayfield, WI 54814-4579

Mailing address

36745 Aiken Rd
Bayfield, WI 54814-4579
Phone (715) 779-3157

Other identifiers 2

IdentifierTypeStateIssuer
2108718OtherPK
32956200MedicaidWI

Other names 1

  • RED CLIFF COMM HEALTH CENTER PHY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Red Cliff Ambulance SVC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1275606808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36745 AIKEN RD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144579",
            "telephone_number": "715-779-3157",
            "fax_number": "715-779-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36745 AIKEN RD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144579",
            "telephone_number": "715-779-3157",
            "fax_number": "715-779-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CLIFF BAND OF :AKE SUPERIOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "TRIBAL CHAIRMAN",
        "authorized_official_telephone_number": "715-779-3700"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108718",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32956200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RED CLIFF COMM HEALTH CENTER PHY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.