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Organization
LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS
Active
Organization
LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS
Active
Other names
LTBB of Odawa Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL HARMON (DIRECT SERVICES ADMINISTRATOR)
(231) 242-1421
Entity
Organization
Contact information
Practice address
1250 LEARS RD, PETOSKEY, MI 49770-9252
(231) 242-1667
(231) 242-1617
Mailing address
1250 LEARS RD, PETOSKEY, MI 49770-9252
(231) 242-1667
(231) 242-1617
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Enumeration date
12/14/2016
Last updated
05/23/2024
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