HANNAHVILLE INDIAN COMMUNITY (NPI# 1922112812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922112812 |
| Entity Type | Organization |
| Organization Name | HANNAHVILLE INDIAN COMMUNITY |
| Other Organization Name | HANNAHVILLE HEALTH CENTER PHARMACY |
| Practice Address |
W365 Us 2 & 41 Suite 600 Wilson MI 49896 |
| Mailing Address |
W365 Us 2&41 Suite 600 Wilson MI 49896 |
| Practice Telephone | 9067232560 |
| Practice Fax Number | 9067232566 |
| Mailing Telephone | 9067232560 |
| Mailing Fax Number | 9067232566 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2017-04-06 |
| Authorized Official Name | GAYLE MESHIGAUD (DIRECTOR OF HEALTH AND HUMAN SERVIC) |
| Authorized Official Telephone | 9067232500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 5301006526 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2043505 | 01 | |
| MI | 3318839 | 05 |
| Other Name | Type Code |
|---|---|
| HANNAHVILLE HEALTH CENTER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457434243 | Hannahville Indian Community | Community/Behavioral Health | 3071 D Rd, Bark River, MI 49807-9716 | 2006-10-23 |
| 1790869436 | Hannahville Indian Community | Clinic/Center | N15019 Hannahville B1 Rd, Wilson, MI 49896 | 2006-10-25 |
| Street Address |
W365 US 2 & 41 SUITE 600 |
| City | WILSON |
| State | MI |
| Zip Code | 49896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528412780 | Jesse Bingham | Physical Therapy Assistant | N14010 Depas Ln, Wilson, MI 49896 | 2016-04-14 |
| 1275743676 | Lori Jean Macintosh | Registered Nurse | N15019 Hannahville B1 Road, Wilson, MI 49896 | 2007-05-23 |
| 1760551774 | Mary Susanne Miller | Psychologist | N15019 Hannahville B1 Rd., Wilson, MI 49896 | 2006-11-06 |
| 1467551291 | Hannahville Health Center Pharmacy | Clinic/Center | N15019 Hannahville B-1 Rd, Wilson, MI 49896 | 2006-09-21 |
| 1154331205 | Sally J Oliver | Pharmacist | N15019 Hannahville B-1 Road, Wilson, MI 49896 | 2006-08-09 |
| 1316956345 | Jodi L Greenfield | Family Medicine | N15019, Wilson, MI 49896 | 2006-08-07 |
| 1184644551 | Erin Marie Davis | Dietitian, Registered | N15019 Hannahville B1 Rd, Wilson, MI 49896 | 2006-07-20 |
| 1154531549 | David Alan Berg | Social Worker | N15019 Hannahville B1 Rd, Wilson, MI 49896 | 2007-05-23 |
| 1790869436 | Hannahville Indian Community | Clinic/Center | N15019 Hannahville B1 Rd, Wilson, MI 49896 | 2006-10-25 |
| 1043751407 | Benjamin Richards | Nurse Practitioner | N13871 County Road 557, Wilson, MI 49896-9772 | 2017-03-17 |
| Find all providers in zip 49896 | ||||
| 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.