Organization
SAULT TRIBE OF CHIPPEWA INDIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE L CULFA (DIVISION OF 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
152W00000X
Optometrist
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A76010
BC/BS OF MI
MI
Enumeration date
02/15/2008
Last updated
05/30/2008
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