Menominee Tribal Clinic Pharmacy

LBN: Menominee Indian Tribe Of Wisconsin
Menominee Tribal Clinic Pharmacy is an health care organization with primary practice located at W3275 Wolf River Road , Keshena WI 54135. The organization recently has only one registered license in Suppliers / Clinic Pharmacy, which is considered as the primary health care specialty. Menominee Indian Tribe Of Wisconsin can be contacted via phone (715) 799-3361, or through Waukau, Jerry L via phone (715) 799-3361.

Contact Information

Primary practice address
W3275 Wolf River Road Keshena WI 54135
Phone: (715) 799-3361
Fax: (715) 799-3099
Website:
Map and Directions
Authorized official contact:
Name: Waukau, Jerry L
Phone: (715) 799-3361

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Clinic Pharmacy 3336C0002X 7848-042 Wisconsin

Profile Details

NPI number 1972545010
LBN Legal business name Menominee Indian Tribe Of Wisconsin
DBA Doing business as Menominee Tribal Clinic Pharmacy
Authorized official Waukau, Jerry L
Entity Organization
Organization subpart 1 No
Enumeration date Jun 12th, 2006
Last updated Mar 7th, 2023 - about last year

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 1972545010 NPPES
Wisconsin MEDICAID 32955700
Wisconsin Other 5118446

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