LITTLE RIVER BAND OF OTTAWA INDIANS (NPI# 1467997239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467997239 |
| Entity Type | Organization |
| Organization Name | LITTLE RIVER BAND OF OTTAWA INDIANS |
| Other Organization Name | LITTLE RIVER BAND OF OTTAWA INDIANS PHARMACY |
| Practice Address |
2608 Government Center Dr Manistee MI 49660-8302 |
| Practice Telephone | 2313986853 |
| Practice Fax Number | 2317231523 |
| Mailing Telephone | 2313986853 |
| Mailing Fax Number | 2317231523 |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2017-08-31 |
| Authorized Official Name | KEITH T JACQUE (CHIEF PHARMACIST) |
| Authorized Official Telephone | 2313986853 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
5301011115 | MI | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301011115 | MI | Suppliers |
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 5301011115 | MI | Suppliers |
| Other Name | Type Code |
|---|---|
| Little River Band of Ottawa Indians Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154590917 | Little River Band of Ottawa Indians | Clinic/Center | 2608 Government Center Dr, Manistee, MI 49660-8302 | 2008-02-26 |
| Street Address |
2608 GOVERNMENT CENTER DR |
| City | MANISTEE |
| State | MI |
| Zip Code | 49660-8302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154590917 | Little River Band of Ottawa Indians | Clinic/Center | 2608 Government Center Dr, Manistee, MI 49660-8302 | 2008-02-26 |
| 1386807212 | Daryl B Wever | Podiatrist | 2608 Government Center Dr, Manistee, MI 49660-8302 | 2008-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083192306 | Margaret R Batzer | Acupuncturist | 352 1st St, Manistee, MI 49660 | 2018-07-30 |
| 1821590373 | Esther Sigurdardottir | Physical Therapist | 1465 E. Parkdale Av, Manistee, MI 49660 | 2018-03-01 |
| 1104328657 | Bryan Keith Kidd | Physical Therapist | 1465 Parkdale Avenue, Manistee, MI 49660 | 2018-03-01 |
| 1790153799 | Deborah Ann Brandt | Registered Nurse | 318 River Street, Friends Who Care, Manistee, MI 49660 | 2015-09-08 |
| 1265811624 | Joyce Eileen Copeland | Assisted Living Facility | 3644 Chippewa Hwy, Manistee, MI 49660 | 2015-05-19 |
| 1275927931 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 16 Caberfae Hwy, Manistee, MI 49660 | 2015-03-20 |
| 1518244912 | Mara Lane Mckinley | Nurse Practitioner | 1465 E. Parkdale Ave3., Manistee, MICHIGAN 49660 | 2011-11-14 |
| 1477749406 | Catherine Imelda Oertel | Social Worker | 2198 Us 31 South, Manistee, MI 49660 | 2007-09-24 |
| 1811109051 | Goodwill Optical Inc | Optometrist | 282 12th St, Manistee, MI 49660 | 2007-05-03 |
| 1144364381 | Layne Christopher Godzina | Dentist | 422 First Street, Manistee, MI 49660 | 2007-02-19 |
| Find all providers in zip 49660 | ||||
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669786257 | Pokagon Band of Potawatomi Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 32652 Kno Dr, Dowagiac, MI 49047 | 2010-08-06 |
| 1508957747 | Sault Tribe of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 5698 W Hwy Us 2, Manistique, MI 49854 | 2006-09-27 |
| 1588108260 | Little Traverse Bay Bands of Odawa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1250 Lears Rd, Petoskey, MI 49770-9252 | 2016-12-14 |
| 1891871539 | Sault Tribe of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 2864 Ashmun Street, Sault Sainte Marie, MI 49783 | 2006-10-27 |
| 1346331584 | Sault Tribe of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1140 N State St, Suite 2805, Saint Ignace, MI 49781-1048 | 2006-09-27 |
| 1316904337 | Bay Mills Indian Community | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 12124 W Lakeshore Dr, Brimley, MI 49715-9319 | 2006-04-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.