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SAULT TRIBE OF CHIPPEWA INDIANS NPI 1477721058


NPI Information

NPI: 1477721058
Provider Name: SAULT TRIBE OF CHIPPEWA INDIANS
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 23D0865798

Address:
2864 ASHMUN ST
SAULT SAINTE MARIE, MI
ZIP 49783
Phone: (906) 632-5200
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SAULT TRIBE OF CHIPPEWA INDIANS is a federally qualified health center (fqhc) clinic center in Sault Sainte Marie, MI. SAULT TRIBE OF CHIPPEWA INDIANS NPI is 1477721058. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2864 ASHMUN ST
SAULT SAINTE MARIE, MI
ZIP 49783-740
Phone: (906) 632-5200
Fax: (906) 632-5276

The provider's authorized official is Bonnie L Culfa .
The authorized official title is Division Of Health Director and has the following contact phone number (906) 632-5200.

The CLIA number assigned to this NPI record is 23D0865798 - public health laboratories with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2008 and was last updated on 10/20/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1231923MEDICARE OSCAR/CERTIFICATIONMICHIGAN
2231922MEDICARE OSCAR/CERTIFICATION
3231841MEDICARE OSCAR/CERTIFICATION
4231838MEDICARE OSCAR/CERTIFICATION
5231843MEDICARE OSCAR/CERTIFICATION
60A76001MEDICARE OSCAR/CERTIFICATION
70A76001OTHERMICHIGANBC/BS OF MI
8231842MEDICARE OSCAR/CERTIFICATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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