BAD RIVER CLINIC PHARMACY – NPI #1710222989
Clinic/Center

BAD RIVER CLINIC PHARMACY is an AHC clinic located in ASHLAND, WI. NPPES has assigned the NPI number 1710222989 to BAD RIVER CLINIC PHARMACY on November 29, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BAD RIVER CLINIC PHARMACY” is a dba name, the actual legal business name for this organization is BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS.. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 2 years ago on Jun 03, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BAD RIVER CLINIC PHARMACY below.

NPI Profile for
BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS.

NPI Number
1710222989
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS.
Doing Business As (dba): BAD RIVER CLINIC PHARMACY
Primary location
53585 NOKOMIS RD
ASHLAND, WI 54806-4272
Phone: (715) 682-7133 Fax:
Mailing address
Same as primary location
Organization Subpart
Yes - BAD RIVER CLINIC PHARMACY is subpart of another organization.
Authorized Official
JUNE WILLIAMS
BILLING/PRC MANAGER
Phone: (715) 682-7133
Updated
Certification Date
Jun 03, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.