Organization
SAULT TRIBE OF CHIPPEWA INDIANS
Active
Parent organization
SAULT TRIBE OF CHIPPEWA INDIANS
Other names
Sault Tribal Health Center Laboratory
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAULT TRIBE OF CHIPPEWA INDIANS
Authorized official
BONNIE L CULFA RN MSN (HEALTH DIRECTOR)
(906) 632-5200
Entity
Organization
Contact information
Practice address
2864 ASHMUN ST, SAULT SAINTE MARIE, MI 49783-3740
(906) 632-5200
(906) 632-5276
Mailing address
2864 ASHMUN ST, SAULT SAINTE MARIE, MI 49783-3740
(906) 632-5200
(906) 632-5276
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
23D0674935
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A71500
BLUE CROSS & BLUE SHIELD
MI
01
—
23D0674935
CLIA NUMBER
MI
05
—
3516048
—
MI
Enumeration date
01/18/2007
Last updated
12/27/2007
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