Organization
SAGINAW CHIPPEWA INDIAN TRIBE
Active
Other names
Cardinal Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH JACQUE (PHCY MANAGER)
(989) 317-3700
Entity
Organization
Contact information
Practice address
2410 S LEATON RD, STE 8, MOUNT PLEASANT, MI 48858-8639
(989) 317-3700
(989) 317-3702
Mailing address
2410 S LEATON RD, STE 8, MOUNT PLEASANT, MI 48858-8639
(989) 317-3700
(989) 317-3702
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008924
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117020
PK
—
Enumeration date
09/17/2008
Last updated
01/20/2016
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