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LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

Medical Equipment Supplier Yellow Pages

Lac Du Flambeau, Wisconsin

Provider NPI: 1447271408

Organization Information:
Organization Name:  LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS


Practice Location:
129 OLD ABE RD  LAC DU FLAMBEAU, WI 54538 US
Tel: 715-588-3371  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y332800000XSuppliers
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
WI8933-042

Other Provider Identifiers:

IssuerNumberStateType
NCPDP PROVIDER IDENTIFICATION NUMBER512238201
32956800WI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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