OrganizationActive
Mashantucket Pequot Tribal
NPI 1578886461 · Mail Order Pharmacy · Mashantucket, CT
Mashantucket Pequot Tribal is a Mail Order Pharmacy organization in Mashantucket, CT (NPI 1578886461).
Provider details
- NPI number
- 1578886461
- Entity type
- Organization
- Primary specialty
- Mail Order PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Edward Moldenhauer, Director of Pharmacy Operation(860) 396-2058
- License
- 285960015 (CT)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1 Annie George Dr
Bldg 1
Mashantucket, CT 06338-3801
Phone: (860) 396-6438
Fax: (800) 779-6329
Street-level locationGet directions
Mailing address
1 Annie George Dr
Mashantucket, CT 06338-3801
Other names (DBA / former)
- Doing business as
- Pequot Health Care
Registry dates
- Enumerated
- 2010-03-05
- Last updated
- 2011-04-01
Frequently asked questions
- What is Mashantucket Pequot Tribal's NPI number?
- Mashantucket Pequot Tribal's National Provider Identifier (NPI) is 1578886461, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mashantucket Pequot Tribal?
- Mashantucket Pequot Tribal is classified in the NPPES registry as Mail Order Pharmacy (Suppliers).
- Where is Mashantucket Pequot Tribal located?
- Mashantucket Pequot Tribal's practice location on file with NPPES is 1 Annie George Dr, Mashantucket, CT 06338-3801.
- What is Mashantucket Pequot Tribal's phone number?
- The practice phone number listed in the NPPES registry for Mashantucket Pequot Tribal is (860) 396-6438.
- Who is the authorized official for Mashantucket Pequot Tribal?
- The authorized official listed on Mashantucket Pequot Tribal's NPPES record is Edward Moldenhauer, Director of Pharmacy Operation. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mashantucket Pequot Tribal's NPI active?
- Yes — Mashantucket Pequot Tribal's NPI (1578886461) is active in the NPPES registry as of the last update on 2011-04-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.