| NPI | 1760536007 |
|---|---|
| Doing Business As | LAC VIEUX DESERT HEALTH CENTER AND PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SADIE VALLIERE Health Director 906-358-4587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MI 5301006253) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2021-05-18 |