Upper Mattaponi Indian Tribe

LBN: Upper Mattaponi Indian Tribe
Upper Mattaponi Indian Tribe is an health care organization with primary practice located at 27 Commerce Lane , King William VA 23086. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty. Upper Mattaponi Indian Tribe can be contacted via phone (804) 769-2015, or through Tupponce, Steven via phone (804) 769-2015.

Contact Information

Primary practice address
27 Commerce Lane King William VA 23086
Phone: (804) 769-2015
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Tupponce, Steven
Phone: (804) 769-2015

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1144077470
LBN Legal business name Upper Mattaponi Indian Tribe
DBA Doing business as
Authorized official Tupponce, Steven
Entity Organization
Organization subpart 1 Yes
Enumeration date May 3rd, 2024
Last updated Jun 27th, 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 1144077470 NPPES
Virginia MEDICAID 30015299710001

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