Lac Vieux Desert Band of Lake Superior Chippewa Indians

Primary specialty

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

Legal business name

LAC VIEUX DESERT BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

Practice address

4559 Wesson Street
Suite 100
Detroit, MI 48210

Phone

(313) 600-0189

NPI assigned

Sep 21, 2026

Last updated

Sep 21, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sadie Valliere

Title

Administrator

Phone

(906) 358-4587

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1376455691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "WATERSMEET",
            "state": "MI",
            "postal_code": "499690009",
            "telephone_number": "313-600-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4559 WESSON STREET",
            "address_2": "SUITE 100",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48210",
            "telephone_number": "313-600-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAC VIEUX DESERT BAND OF LAKE SUPERIOR CHIPPEWA INDIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "VALLIERE",
        "authorized_official_first_name": "SADIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "906-358-4587"
    },
    "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.