OrganizationActive
Little River Band of Ottawa Indians
NPI 1467997239 · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Manistee, MI
Provider details
- NPI number
- 1467997239
- Entity type
- Organization
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
- Authorized official
- Keith Jacque, Chief Pharmacist
- License
- 5301011115 (MI)
Practice location
2608 Government Center Dr
Manistee, MI 49660-8302
Phone: (231) 398-6853
Fax: (231) 723-1523
Mailing address
2608 Government Center Dr
Manistee, MI 49660-8302
Registry dates
- Enumerated
- 2017-01-03
- Last updated
- 2022-12-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.