Lac Du Flambeau Band of Lake Superior Chippewa Indians
NPI #1447271408 in Lac Du Flambeau, Wisconsin
Provider Information
- NPI Number
- 1447271408
- Entity Type
- Organization
- Organization Name
- Lac Du Flambeau Band of Lake Superior Chippewa Indians
- Primary Specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Enumeration Date
- Jul 22, 2006
- Last Updated
- Feb 27, 2017
Practice Location
- Address
- 129 OLD ABE RD
- City
- Lac Du Flambeau
- State
- Wisconsin
- ZIP Code
- 54538
- Phone
- (715) 588-3371
Authorized Official
- Name
- RANDY SAMUELSON
- Title
- ADMINISTRATOR
- Phone
- (715) 588-3371
Specialties & Taxonomy Codes
| Specialty |
|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
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