Mashantucket Pequot Tribal is not a DME supplier for medicare equipments and products.
Mashantucket Pequot Tribal is a Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy in Mashantucket, Connecticut. This organization is also known as sub part of Mashantucket Pequot Tribal. It is located at 1 Annie George Drive, Bldg 1, Mashantucket and it's customer support contact number is 860-396-6435. The authorized person of Mashantucket Pequot Tribal is Dr. John Grossomanides, PHARMD, RPH who is Director Of Pharmacy Services of the pharmacy and his contact number is 860-396-6435. Mashantucket Pequot Tribal 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:
Mashantucket Pequot Tribal 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:
Mashantucket Pequot Tribal
Type:
Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
Location:
1 Annie George Drive, Bldg 1, Mashantucket, Connecticut, 06338-3801
Phone:
860-396-6435
Fax:
800-779-6329
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:
Dr. John Grossomanides
Credentials:
PHARMD, RPH
Position:
Director Of Pharmacy Services
Contact Number:
860-396-6435
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:
1720024524
Parent Organization:
Mashantucket Pequot Tribal
NPI Enumeration Date:
21 Jun, 2006
NPI Last Update On:
16 Apr, 2025
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mashantucket Pequot Tribal are as mentioned below.
Specialization
License Number
State
Status
Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
Primary
Pharmacy
Secondary
Mail Order Pharmacy
Secondary
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
004129210
Medicaid
Connecticut
2000351
Other
Pk
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1 Annie George Drive, Bldg 1 Mashantucket, Connecticut
Zip:
06338-3801
Phone Number:
860-396-6435
Fax Number:
860-396-6212
Patients can reach Mashantucket Pequot Tribal at 1 Annie George Drive, Bldg 1, Mashantucket, Connecticut or can call on customer care at 860-396-6435.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.
Other Pharmacies in Mashantucket, Connecticut
Mashantucket Pequot Tribal Speciality:Mail Order Pharmacy Address: 1 Annie George Dr, Mashantucket, CT Phone: 860-396-6438 Fax: 866-396-6212Mashantucket Pequot Tribal Speciality:Mail Order Pharmacy Address: 1 Annie George Dr, Bldg 1, Mashantucket, CT Phone: 860-396-6438 Fax: 800-779-6329