Organization
BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS.
Active
Parent organization
BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS.
Other names
Bad River Clinic Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS.
Authorized official
JUNE LOUISE WILLIAMS (BILLING/PRC MANAGER)
(715) 682-7133
Entity
Organization
Contact information
Practice address
53585 NOKOMIS RD, ASHLAND, WI 54806-4272
(715) 682-7133
Mailing address
53585 NOKOMIS RD, ASHLAND, WI 54806-4272
(715) 682-7133
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/29/2012
Last updated
06/03/2024
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