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Bay Mills Indian Community

Organization Active NPI Community/Retail Pharmacy · Brimley, MI

NPI 1316904337 · NPPES record last updated Oct 4, 2022

Key facts

NPI
1316904337
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
BAY MILLS INDIAN COMMUNITY
Practice address
12455 W Lakeshore Dr
Brimley, MI 49715-9327
Phone
(906) 248-2031
Fax
(906) 248-8366
NPI assigned
Apr 26, 2006
Organization subpart
No

Authorized official

Name
Mrs. Audrey Breakie
Title
Health - Human Services Director
Phone
(906) 248-8327

Corporate family (same tax ID) 9

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

National Provider Directory

Tax ID family
Bay Mills Health Center (10 organizations share this tax ID)

Locations

12124 W Lakeshore Dr
Brimley, MI 49715
Phone (906) 248-5527

Specialties & licenses

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

Addresses

Primary practice location

12455 W Lakeshore Dr
Brimley, MI 49715-9327

Mailing address

12455 W Lakeshore Dr
Brimley, MI 49715-9327
Phone (906) 248-2031

Other identifiers

IdentifierTypeStateIssuer
2362438MedicaidMI
2362438OtherMINAPB
874998658MedicaidMI

Other names

  • BAY MILLS PHARMACY Doing business as

Other providers in Brimley, MI

All providers in Brimley, MI · Community/Retail Pharmacy in Michigan

Sources for this page

Verify at the official NPI Registry.