Little Traverse Bay Bands Of Odawa Indians

LBN: Little Traverse Bay Bands Of Odawa Indians
Little Traverse Bay Bands Of Odawa Indians is an health care organization with primary practice located at 2390 Mitchell Park Dr Ste D , Petoskey MI 49770-8965. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Little Traverse Bay Bands Of Odawa Indians can be contacted via phone (231) 242-1760, or through Animikwam, Frank via phone (231) 242-1700.

Contact Information

Primary practice address
2390 Mitchell Park Dr Ste D Petoskey MI 49770-8965
Phone: (231) 242-1760
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Animikwam, Frank Doctor of Medicine (MD)
Phone: (231) 242-1700

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1689387821
LBN Legal business name Little Traverse Bay Bands Of Odawa Indians
DBA Doing business as
Authorized official Animikwam, Frank Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 3rd, 2023
Last updated May 23rd, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689387821 NPPES
Michigan MEDICAID 1588108260

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