LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS (NPI# 1588108260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588108260 |
Entity Type | Organization |
Organization Name | LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS |
Other Organization Name | LTBB OF ODAWA PHARMACY |
Practice Address |
1250 Lears Rd Petoskey MI 49770-9252 |
Practice Telephone | 2312421667 |
Practice Fax Number | 2312421617 |
Mailing Telephone | (231) 242-1667 |
Mailing Fax Number | 2312421617 |
Enumeration Date | 2016-12-14 |
Last Update Date | 2017-08-31 |
Authorized Official Name | PHIL HARMON (DIRECT SERVICES ADMINISTRATOR) |
Authorized Official Telephone | 2312421421 |
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 | Suppliers |
Other Name | Type Code |
---|---|
LTBB of Odawa Pharmacy | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235342866 | Little Traverse Bay Bands of Odawa Indians | Community/Behavioral Health | 101 Greenwood, Petoskey, MI 49770 | 2007-05-08 |
1124052816 | Little Traverse Bay Bands of Odawa Indians | Clinic/Center | 1250 Lears Rd., Petoskey, MI 49770-8774 | 2006-07-10 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS | 7500 Odawa Cir, Harbor Springs, MI 49740-9692 |
Street Address |
1250 LEARS RD |
City | PETOSKEY |
State | MI |
Zip Code | 49770-9252 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962427401 | Thomas Lee Sandison | Pharmacist | 1250 Lears Rd, Petoskey, MI 49770-9252 | 2006-07-13 |
1881615391 | Terry J Samuels | Family Medicine | 1250 Lears Rd, Petoskey, MI 49770-8774 | 2006-07-21 |
1174544696 | Carianne Jeffers-wcisel | Physician Assistant | 1250 Lears Rd, Petoskey, MI 49770-9252 | 2006-07-21 |
1649226853 | Russell J Wood | Social Worker | 1250 Lears Rd, Petoskey, MI 49770-9252 | 2006-05-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
Find all providers in zip 49770 |
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 |
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.