RED CLIFF BAND OF :AKE SUPERIOR (NPI# 1275606808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275606808 |
| Entity Type | Organization |
| Organization Name | RED CLIFF BAND OF :AKE SUPERIOR |
| Other Organization Name | RED CLIFF COMM HEALTH CENTER PHY |
| Practice Address |
36745 Aiken Rd Bayfield WI 54814-4579 |
| Practice Telephone | 7157793157 |
| Practice Fax Number | 7157793501 |
| Mailing Telephone | 7157793157 |
| Mailing Fax Number | 7157793752 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | RICHARD PETERSON (TRIBAL CHAIRMAN) |
| Authorized Official Telephone | 7157793700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2108718 | 01 | |
| WI | 32956200 | 05 |
| Other Name | Type Code |
|---|---|
| RED CLIFF COMM HEALTH CENTER PHY | Doing Business As Name - Organization |
| Street Address |
36745 AIKEN RD |
| City | BAYFIELD |
| State | WI |
| Zip Code | 54814-4579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548257249 | Steven C Miszkiewicz | Family Medicine | 36745 Aiken Rd, Bayfield, WI 54814-4579 | 2005-09-29 |
| 1255996526 | Tamara L Kolesar | Counselor | 36745 Aiken Rd, Bayfield, WI 54814-4579 | 2019-05-02 |
| 1588119887 | James E Peacock | Counselor | 36745 Aiken Rd, Bayfield, WI 54814-4579 | 2016-08-17 |
| 1659743136 | Craig O Shanks | Counselor | 36745 Aiken Rd, Bayfield, WI 54814-4579 | 2015-10-23 |
| 1831576214 | Jennifer Kupczyk | Pharmacist | 36745 Aiken Rd, Bayfield, WI 54814-4579 | 2015-05-05 |
| 1063899516 | Nicole Renee Gurnoe | Counselor | 36745 Aiken Rd, Bayfield, WI 54814-4579 | 2015-05-05 |
| 1538197108 | Ann Elizabeth Reitz | Family Medicine | 36745 Aiken Rd, Bayfield, WI 54814-4579 | 2006-06-30 |
| 1497744015 | Red Cliff Band of Lake Superior Chippewa | Clinic/Center | 36745 Aiken Rd, Bayfield, WI 54814-4579 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760830103 | Orthopedic & Spine Therapy of Poplar Sc | Physical Therapist | 33 N 1st St, Bayfield, WI 54814 | 2016-05-26 |
| 1265812481 | Valley Birch, LLC | Community/Behavioral Health | 249 Rittenhouse Avenue, Bayfield, WI 54814 | 2015-06-03 |
| 1205007796 | Red Cliff Band of Lake Superior Chippewa | Social Worker | 88455 Pike Road, Bayfield, WI 54814 | 2008-03-12 |
| 1518137652 | Ellie Heydari | Dentist | 36745 Aiken Rd., Red Cliff Community Health Center, Bayfield, WI 54814 | 2008-03-05 |
| 1174672844 | Red Cliff Band of Lake Superior Chippewa Indians | Ambulance | 37435 Sth 13, Bayfield, WI 54814 | 2007-01-10 |
| 1730257122 | Red Cliff Band of Lake Superior Chippewa | Pharmacist | 88385 Pike Road, Bayfield, WI 54814 | 2006-12-01 |
| 1568484764 | Janice K Wilber | Pharmacist | 88455 Pike Road, Highway 13, Bayfield, WI 54814 | 2006-07-24 |
| 1902077464 | Red Cliff Band of Lake Superior Chippewa | Registered Nurse | 88455 Pike Road, Bayfield, WI 54814 | 2008-03-12 |
| 1083885545 | Red Cliff Band of Lake Superior Chippewa | Durable Medical Equipment & Medical Supplies | 88455 Pike Road, Bayfield, WI 54814 | 2008-03-12 |
| 1730102203 | Barbara M Tellier | Pharmacist | 88455 Pike Road, Highway 13, Bayfield, WI 54814 | 2006-07-25 |
| Find all providers in zip 54814 | ||||
| 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 |
|---|---|---|---|---|
| 1487875787 | St. Croix Tribal Council | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 4404 State Rd 70, Webster, WI 54893 | 2007-05-02 |
| 1487812897 | Ho-chunk Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | S2845 White Eagle Rd, Baraboo, WI 53913-9064 | 2008-06-02 |
| 1386802718 | Ho-chunk Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | N6520 Lumberjack Guy Rd, Black River Falls, WI 54615-5405 | 2008-06-02 |
| 1780702829 | Bad River Band of Lake Superior Tribe of Chippewa Indians Wis | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2007-03-27 |
| 1942331467 | Stockbridge Munsee Community | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | W12802 County Road A, Bowler, WI 54416-0086 | 2007-03-08 |
| 1447271408 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 129 Old Abe Rd, Lac Du Flambeau, WI 54538 | 2006-07-22 |
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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.