Mashantucket Pequot Tribal

NPI #1578886461 in Mashantucket, Connecticut

Provider Information

NPI Number: 1578886461
Entity Type: Organization
Organization Name: Mashantucket Pequot Tribal
Primary Specialty: Pharmacy - Mail Order Pharmacy
Enumeration Date: Mar 5, 2010
Last Updated: Apr 1, 2011

Practice Location

Address: 1 ANNIE GEORGE DR
Address 2: BLDG 1
City: Mashantucket
State: Connecticut
ZIP Code: 06338-3801
Phone: (860) 396-6438

Authorized Official

Name: EDWARD MOLDENHAUER
Title: DIRECTOR OF PHARMACY OPERATION
Phone: (860) 396-2058

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy - Mail Order Pharmacy — Mail Order Pharmacy	3336M0002X	Primary

Similar Providers

Individual Providers

Provider Name	Specialty	City
MRS. Amy D Ricupero, RPH, MED	Pharmacist	Mashantucket	AI Deep Dive
Catherine Ann Koivisto, RPH	Pharmacist	Mashantucket	AI Deep Dive

Organizations

Provider Name	Specialty	City
Icon Health Science	Pharmacy - Mail Order Pharmacy	Norwalk	AI Deep Dive
Mashantucket Pequot Tribal Part of Mashantucket Pequot Tribal	Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy	Mashantucket	AI Deep Dive
Mashantucket Pequot Tribal	Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy	Mashantucket	AI Deep Dive

Want to research this healthcare provider further?