NPIMap

Organization Active NPI

St. Croix Chippewa Indians of Wi

Doing business as St. Croix Tribal Clinic

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Webster, WI
National Provider Identifier
1487875787
Registry record updated Oct 15, 2024
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
ST. CROIX CHIPPEWA INDIANS OF WI
Doing business as
St. Croix Tribal Clinic
St. Croix Tribal Pharmacy
Practice address
4404 State Rd 70
Webster, WI 54893
Phone
(715) 349-8554
Fax
(715) 349-8529
NPI assigned
May 2, 2007
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. CROIX TRIBAL COUNCILAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Amber Heinz
Title
Health Director
Phone
(715) 349-8554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary

Addresses

Primary practice location

4404 State Rd 70
Webster, WI 54893

Mailing address

4404 State Rd 70
Webster, WI 54893
Phone (715) 349-8554

Other names 2

  • St. Croix Tribal Clinic Doing business as
  • St. Croix Tribal Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Croix Tribal Council7 organizations share this tax ID, including this one
Part of
St Croix Tribal Council

Other organizations with this tax ID 6

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

Locations

4404 State Road 70
Webster, WI 54893
Phone (715) 349-8554

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1487875787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 STATE RD 70",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "54893",
            "telephone_number": "715-349-8554",
            "fax_number": "715-349-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 STATE RD 70",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "54893",
            "telephone_number": "715-349-8554",
            "fax_number": "715-349-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX CHIPPEWA INDIANS OF WI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. CROIX TRIBAL COUNCIL",
        "enumeration_date": "2007-05-02",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "HEINZ",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "715-349-8554"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Croix Tribal Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Croix Tribal Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Croix Tribal Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Webster, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.