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Organization

ST REGIS MOHAWK TRIBE

Active
Other names
ST REGIS MOHAWK HEALTH SERVICES
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL JOHN COOK (DIRECTOR)
(518) 358-3141
Entity
Organization

Contact information

Practice address
412 STATE ROUTE 37, AKWESASNE, NY 13655-3109
(518) 358-3141
(518) 358-2797
Mailing address
412 STATE ROUTE 37, AKWESASNE, NY 13655-3109
(518) 358-3141
(518) 358-2797

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1653200R
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00651785
NY
05
01178234
NY
Enumeration date
08/24/2005
Last updated
07/14/2025
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Product
  • Claims
  • Eligibility checks
  • EDI platform