PEQUOT HEALTH CARE
NPI 1003036435
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Mashantucket, CT

Q: What is Mashantucket Pequot Tribal's NPI number?

The NPI number for Mashantucket Pequot Tribal is 1003036435. It was assigned to this organization in the NPPES registry on April 26, 2007. The provider is doing business as Pequot Health Care.

Q: What is Mashantucket Pequot Tribal's specialty?

The primary specialty registered for this NPI is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy with taxonomy code 332800000X.

Active since April 26, 2007

1 ANNIE GEORGE DR, MASHANTUCKET, CT 06338(860) 396-6438(866) 396-6212 Get Directions Write a Review

NPPES record last updated: April 1, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Pequot Health Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEQUOT HEALTH CARE (NPI 1003036435) is a healthcare organization registered as an indian health service/tribal/urban indian health (i/t/u) pharmacy in Mashantucket, Connecticut and active in the NPI registry since April 2007. The organization lists Edward Moldenhauer, Director Of Pharmacy Operation, as its authorized official.

NPPES Registry Identity

NPI1003036435

Entity TypeOrganization

Primary Taxonomy332800000X

Legal Business NameMASHANTUCKET PEQUOT TRIBAL

Location Address1 ANNIE GEORGE DRMashantucket, CT 06338-3801

Mailing Address1 Annie George Dr, Po Box 3559Mashantucket, CT 06338-3801 · (860) 369-2058 · Fax (860) 396-6212

Phone(860) 396-6438

Fax(866) 396-6212

Organization SubpartNo

Authorized OfficialEdward MoldenhauerDirector Of Pharmacy Operation · (860) 396-2058

Enumeration DateApril 26, 2007

Last NPPES UpdateApril 1, 2011

✔ NPI 1003036435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers

Taxonomy Code332800000X

License✔ Licensed in CT · ISH285960015

Definition

An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.

Also ListedPharmacyTaxonomy 333600000X

Also ListedPharmacy · Mail Order PharmacyTaxonomy 3336M0002X

Also ListedPharmacy · Managed Care Organization PharmacyTaxonomy 3336M0003X

1 ANNIE GEORGE DR, Mashantucket, CT 06338

Open in Google Maps ↗

Other Names 1

Doing Business AsPequot Health Care

Other Identifiers 2

Other0718619Ncpdp Provider Identification Number

Medicaid004129210CT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Highmark Blue Cross Blue Shield Delaware, Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROL LEA OURS RPH, AEC

Pharmacist

1 ANNIE GEORGE DR
MASHANTUCKET, CT 06338

Southeastern Connecticut Planning Region (888) 779-6362

JENNIFER MCCUE RPH

Pharmacist

1 ANNIE GEORGE DR, BLDG 1
MASHANTUCKET, CT 06338

Southeastern Connecticut Planning Region (860) 396-6438

TIMOTHY J POOLE PHARMD

Pharmacist

1 ANNIE GEORGE DR
MASHANTUCKET, CT 06338

Southeastern Connecticut Planning Region (888) 779-6362

MRS. AMY D RICUPERO RPH, MED

Pharmacist

1 ANNIE GEORGE DR
MASHANTUCKET, CT 06338

Southeastern Connecticut Planning Region (888) 779-6362

MASHANTUCKET PEQUOT TRIBAL

Pharmacy (Mail Order Pharmacy)

1 ANNIE GEORGE DR, BLDG 1
MASHANTUCKET, CT 06338

Southeastern Connecticut Planning Region (860) 396-6438

CATHERINE ANN KOIVISTO RPH

Pharmacist

1 ANNIE GEORGE DR
MASHANTUCKET, CT 06338

Southeastern Connecticut Planning Region (888) 779-6362

MILLIE WHITE

Pharmacist

1 ANNIE GEORGE DR
MASHANTUCKET, CT 06338

Southeastern Connecticut Planning Region (888) 779-6362

CARLA O'DONNELL RPH

Pharmacist

1 ANNIE GEORGE DR
MASHANTUCKET, CT 06338

Southeastern Connecticut Planning Region (860) 396-6430

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mashantucket Pequot Tribal's NPI number?

The NPI number for Mashantucket Pequot Tribal is 1003036435. It was assigned to this organization in the NPPES registry on April 26, 2007. The provider is doing business as Pequot Health Care.

Where is Mashantucket Pequot Tribal located?

Mashantucket Pequot Tribal is located at 1 Annie George Dr, Mashantucket, CT 06338. The listed phone number is (860) 396-6438.

What is Mashantucket Pequot Tribal's specialty?

The primary specialty registered for this NPI is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy with taxonomy code 332800000X.

What insurance does Mashantucket Pequot Tribal accept?

Health plans from AvMed, Highmark Blue Cross Blue Shield Delaware and Highmark Blue Cross Blue Shield West Virginia list Mashantucket Pequot Tribal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mashantucket Pequot Tribal was last updated on April 1, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.