Lac Du Flambeau Band Of Lake Superior Chippewa Indians
Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
129 Old Abe Rd, Lac Du Flambeau
Wisconsin, 54538
715-588-3371 715-588-2039
Lac Du Flambeau Band Of Lake Superior Chippewa Indians is a Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy in Lac Du Flambeau, Wisconsin. It is located at 129 Old Abe Rd, Lac Du Flambeau and it's customer support contact number is 715-588-3371. The authorized person of Lac Du Flambeau Band Of Lake Superior Chippewa Indians is Randy Samuelson who is Administrator of the pharmacy and his contact number is 715-588-3371. Active license number of Lac Du Flambeau Band Of Lake Superior Chippewa Indians is 8933-042 for Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy in Wisconsin. Lac Du Flambeau Band Of Lake Superior Chippewa Indians accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Lac Du Flambeau Band Of Lake Superior Chippewa Indians is 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.
Pharmacy Details:
Lac Du Flambeau Band Of Lake Superior Chippewa Indians type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Lac Du Flambeau Band Of Lake Superior Chippewa Indians |
| Type: | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy |
| Location: | 129 Old Abe Rd, Lac Du Flambeau,
Wisconsin, 54538 |
| Phone: | 715-588-3371 |
| Fax: | 715-588-2039 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Randy Samuelson |
| Position: | Administrator |
| Contact Number: | 715-588-3371 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1447271408 |
| NPI Enumeration Date: | 22 Jul, 2006 |
| NPI Last Update On: | 27 Feb, 2017 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lac Du Flambeau Band Of Lake Superior Chippewa Indians are as mentioned below.
| Specialization | License Number | State | Status | |
| Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy | 8933-042 | Wisconsin | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 32956800 | Medicaid | Wisconsin | |
| 5122382 | Other | | Ncpdp Provider Identification Number |
Medicare Enrollment:
Lac Du Flambeau Band Of Lake Superior Chippewa Indians is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 5496707242 | O20100930069478 | Lac Du Flambeau Band Of Lake Superior Chippewa Indians | DME SUPPLIER - PHARMACY |
Products Available:
Lac Du Flambeau Band Of Lake Superior Chippewa Indians has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Diabetic Shoes & Inserts: Custom Fabricated | • Diabetic Shoes & Inserts: Prefabricated |
| • Infusion Pumps & Supplies: Insulin Infusion | • Nebulizer Equipment & Supplies |
| • Ostomy Supplies | • Surgical Dressings |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 129 Old Abe Rd,
Lac Du Flambeau, Wisconsin |
| Zip: | 54538 |
| Phone Number: | 715-588-3371 |
| Fax Number: | 715-588-2039 |
Patients can reach Lac Du Flambeau Band Of Lake Superior Chippewa Indians at
129 Old Abe Rd, Lac Du Flambeau, Wisconsin or can
call on customer care at 715-588-3371.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.