Organization
BAY MILLS INDIAN COMMUNITY
Active
Parent organization
BAY MILLS INDIAN COMMUNITY
Other names
Mitigoons Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAY MILLS INDIAN COMMUNITY
Authorized official
LUCY PARISH DEWILDT (ASSISTANT HHS DIRECTOR)
(906) 248-8372
Entity
Organization
Contact information
Practice address
204 E PORTAGE AVE, SAULT SAINTE MARIE, MI 49783-2054
(906) 248-8621
(906) 248-8622
Mailing address
12455 W LAKESHORE DR, BRIMLEY, MI 49715-9327
(906) 248-8366
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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