Organization
SAGINAW CHIPPEWA INDIAN TRIBE
Active
Other names
Nimkee Memorial Wellness Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK J. CLOUTIER (TRIBAL CHIEF)
(989) 775-4200
Entity
Organization
Contact information
Practice address
2591 S LEATON RD, MT PLEASANT, MI 48858
(989) 775-4924
(989) 775-4990
Mailing address
2591 S LEATON RD, MT PLEASANT, MI 48858
(989) 775-4924
(989) 775-4990
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
BN2651861
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2348844
NCPDP
MI
05
—
2754368
—
MI
01
—
540C707520
BCBS
MI
Enumeration date
09/06/2006
Last updated
04/10/2017
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