Organization
ST REGIS MOHAWK TRIBE
Active
Parent organization
ST REGIS MOHAWK TRIBE
Other names
St Regis Mohawk Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST REGIS MOHAWK TRIBE
Authorized official
MICHAEL COOK (HEALTH DIRECTOR)
(518) 358-3141
Entity
Organization
Contact information
Practice address
404 STATE ROUTE 37, HOGANSBURG, NY 13655-3109
(518) 358-3141
(518) 358-9175
Mailing address
404 STATE ROUTE 37, HOGANSBURG, NY 13655-3109
(518) 358-3141
(518) 358-9175
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
028067
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028067
REGISTRATION NUMBER
NY
01
—
3304057
NCPDP
NY
Enumeration date
04/03/2007
Last updated
11/15/2024
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