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 ROAD, ASHLAND, WI 54806-4272
(715) 682-7133
(715) 685-8810
Mailing address
53585 NOKOMIS ROAD, ASHLAND, WI 54806-4272
(715) 682-8518
(715) 682-7753
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32787800
—
WI
Enumeration date
03/27/2007
Last updated
06/03/2024
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