Mashantucket Pequot Tribal
NPI 1720024524 · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Mashantucket, CT
Mashantucket Pequot Tribal is a Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy organization in Mashantucket, CT (NPI 1720024524).
Provider details
- NPI number
- 1720024524
- Entity type
- Organization
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
- Parent organization
- Mashantucket Pequot Tribal
- Organization subpart
- Yes
- Authorized official
- John Grossomanides, Director of Pharmacy Services(860) 396-6435
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
- Mail Order Pharmacy3336M0002X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
Mailing address
Other names (DBA / former)
- Doing business as
- Pequot Health Care
Registry dates
- Enumerated
- 2006-06-21
- Last updated
- 2025-04-16
Frequently asked questions
- What is Mashantucket Pequot Tribal's NPI number?
- Mashantucket Pequot Tribal's National Provider Identifier (NPI) is 1720024524, 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 Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Suppliers).
- Where is Mashantucket Pequot Tribal located?
- Mashantucket Pequot Tribal's practice location on file with NPPES is 1 Annie George Drive, 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) 396-6435.
- Who is the authorized official for Mashantucket Pequot Tribal?
- The authorized official listed on Mashantucket Pequot Tribal's NPPES record is John Grossomanides, Director of Pharmacy Services. 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 (1720024524) is active in the NPPES registry as of the last update on 2025-04-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.