LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS (NPI# 1447271408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447271408 |
| Entity Type | Organization |
| Organization Name | LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS |
| Other Organization Name | PETER CHRISTENSEN HEALTH CENTER |
| Practice Address |
129 Old Abe Rd Lac Du Flambeau WI 54538 |
| Practice Telephone | 7155883371 |
| Practice Fax Number | 7155882039 |
| Mailing Telephone | 7155883371 |
| Mailing Fax Number | 7155882039 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2017-02-27 |
| Authorized Official Name | RANDY SAMUELSON (ADMINISTRATOR) |
| Authorized Official Telephone | 7155883371 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 8933-042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5122382 | 01 | |
| WI | 32956800 | 05 |
| Other Name | Type Code |
|---|---|
| PETER CHRISTENSEN HEALTH CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669970729 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Clinic/Center | 3378 N. Schilleman Rd, Lac Du Flambeau, WI 54538-0815 | 2018-01-24 |
| 1861885014 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Community/Behavioral Health | 533 Peace Pipe Rd, Lac Du Flambeau, WI 54538-9123 | 2015-03-12 |
| 1427347426 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Clinic/Center | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-9682 | 2011-03-31 |
| 1306016563 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Case Management | 533 Peace Pipe Road, Lac Du Flambeau, WI 54538-0189 | 2008-03-04 |
| 1134235047 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Clinic/Center | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2006-08-22 |
| Street Address |
129 OLD ABE RD |
| City | LAC DU FLAMBEAU |
| State | WI |
| Zip Code | 54538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992795223 | Kenneth R Ninham | Counselor | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2005-10-27 |
| 1578175063 | Lucas C Daniels | Nurse Practitioner | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2020-08-18 |
| 1841801388 | Andrew Friedley | Pharmacist | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2020-08-10 |
| 1386255834 | Nicholis Ross Laporte | Pharmacist | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2020-08-10 |
| 1689145443 | Alissa R Martin | Social Worker | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2018-12-05 |
| 1831556901 | Katrina Angel Mares | Chiropractor | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2016-01-20 |
| 1831570761 | Shane Brahm | Optometrist | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2015-06-16 |
| 1447690375 | Emily E Busha | Physician Assistant | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2013-06-25 |
| 1770812505 | Scott C Kuehn | Counselor | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2009-12-07 |
| 1134235047 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Clinic/Center | 129 Old Abe Rd, Lac Du Flambeau, WI 54538-9386 | 2006-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265757256 | Stacey Dean | Registered Nurse | 8727 West Squaw Lake Road, Lac Du Flambeau, WI 54538 | 2010-04-01 |
| 1447398532 | Wendy Lindstrom | Counselor | 533 Peace Pipe Rd, Lac Du Flambeau, WI 54538 | 2007-02-02 |
| 1932295581 | Rick Lee Howe | Pharmacist | 450 Ols Abe Road, Lac Du Flambeau, WI 54538 | 2006-10-04 |
| 1902990534 | Timothy P. Obukowicz | Pharmacist | 450 Old Abe Road, Lac Du Flambeau, WI 54538 | 2006-10-03 |
| 1295849420 | Brian D Schafer | Pharmacist | 129 Old Abe Road, Lac Du Flambeau, WI 54538 | 2006-08-17 |
| 1720071723 | Town of Lac Du Flambeau | Ambulance | 614 Wild Rice Avenue, Lac Du Flambeau, WI 54538 | 2005-08-24 |
| 1508223066 | Amber Bickler | Dental Hygienist | 128 Old Abe Road, Lac Du Flambeau, WI 54538 | 2016-01-28 |
| 1689712770 | Linda M Daniels | Counselor | 533 Peace Pipe Rd, Lac Du Flambeau, WI 54538 | 2007-02-02 |
| 1477611432 | Gary Louis Gusmerotti | Dentist | 128 Old Abe Rd, Lac Du Flambeau, WI 54538-0128 | 2006-12-04 |
| 1073940136 | Sarah Jean Galloy | Dental Hygienist | 128 Old Abe Road, Lac Du Flambeau, WI 54538-0128 | 2013-10-03 |
| Find all providers in zip 54538 | ||||
| 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 |
| City | LAC DU FLAMBEAU |
| Zip Code | 54538 |
Please comment or provide details below to improve the information on LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS.
| 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.