Organization
BAY MILLS INDIAN COMMUNITY
Active
Other names
BAY MILLS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AUDREY BREAKIE (HEALTH - HUMAN SERVICES DIRECTOR)
(906) 248-8327
Entity
Organization
Contact information
Practice address
12455 W LAKESHORE DR, BRIMLEY, MI 49715-9327
(906) 248-2031
(906) 248-8366
Mailing address
12455 W LAKESHORE DR, BRIMLEY, MI 49715-9327
(906) 248-2031
(906) 248-2032
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2362438
NAPB
MI
05
—
2362438
—
MI
05
—
874998658
—
MI
Enumeration date
04/26/2006
Last updated
10/04/2022
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