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General NPI Number Information
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NPI Number | 1427879576
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Entity Type | Organization
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Legal Business Name | NOTTAWASEPPI HURON BAND OF THE POTAWATOMI PHARMACY
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 11177 MICHIGAN AVE E
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City | BATTLE CREEK
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State | MI
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Zip | 49014-8904
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Country | US
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Telephone | 269-704-8593
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Fax | 269-729-5151
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Provider Business Mailing Address
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Address Line | 11177 MICHIGAN AVE E
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City | BATTLE CREEK
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State | MI
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Zip | 49014-8904
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Country | US
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Telephone | 269-578-9873
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Fax |
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | ANDREW STRAATSMA
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Credential |
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Telephone | 269-251-7579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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