Passamaquoddy Tribal Council

Primary specialty

Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X

License

PH50000192 Issued in ME

Legal business name

PASSAMAQUODDY TRIBAL COUNCIL

Doing business as

Pleasant Point Health Center

Practice address

11 Back Rd
Pleasant Point, ME 04667-4119

Phone

(207) 853-0644

Fax

(207) 853-6230

NPI assigned

Oct 25, 2006

Last updated

Apr 8, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

PLEASANT POINT HEALTH CENTER PHARMACYAs reported in NPPES

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

Authorized official

Name

Kirk Altvater

Title

Health Center Director

Phone

(207) 853-5010

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pleasant Point Health Center Doing business as

Tax ID family

Passamaquoddy Tribal Council3 organizations share this tax ID, including this one

Part of

Passamaquoddy Tribal Council

Other organizations with this tax ID 2

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

• Passamaquoddy Tribal Council

  dba Pleasant Point Health Center

  • Federally Qualified Health Center (FQHC)
  • Pleasant Point, ME
  • NPI 1760474613
  NPD tax ID
• Passamaquoddy Tribal Council

  dba Sipayik Ambulance Service

  • Land Ambulance
  • Perry, ME
  • NPI 1902967060
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Frederick Breckinridge, RPH

  • Pharmacist
  • Perry, ME
  • NPI 1457455842
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1366526188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 351",
            "city": "PERRY",
            "state": "ME",
            "postal_code": "046670351",
            "telephone_number": "207-853-0644",
            "fax_number": "207-853-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BACK RD",
            "city": "PLEASANT POINT",
            "state": "ME",
            "postal_code": "046674119",
            "telephone_number": "207-853-0644",
            "fax_number": "207-853-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAMAQUODDY TRIBAL COUNCIL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLEASANT POINT HEALTH CENTER PHARMACY",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A",
        "authorized_official_last_name": "ALTVATER",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "HEALTH CENTER DIRECTOR",
        "authorized_official_telephone_number": "207-853-5010"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "ME",
            "license": "PH50000192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107300100",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pleasant Point Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carsten Mackeldey
• Kathleen Alfreda Majka, R.D., L.D
• Tiffany M Martinez, PMHNP
• Susan C Neptune
• Linda Mae Nicholas, LCPC/LADC
• Passamaquoddy Tribal Council (Pleasant Point Health Center)
• Pleasant Point Passamaquoddy School Committee
• Alahna M Roach

• Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Pleasant Point, ME
• Providers in Pleasant Point, ME by specialty
• Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.