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Mashantucket Pequot Tribal

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Mashantucket, CT · enumerated 2007 · authorized official Edward Moldenhauer, Director of Pharmacy Operation.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1003036435

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Registry record

Entity type Organization (Type 2)
Legal business name Mashantucket Pequot Tribal
Other name <Unavail>
Practice address 1 Annie George Dr, Mashantucket, CT, 06338
Phone (860) 396-6438
Fax (866) 396-6212
Enumeration date Apr 26, 2007
Last updated in NPPES Apr 1, 2011

Taxonomy & classification

332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Suppliers · License ISH285960015 (CT) Primary
333600000X Pharmacy Suppliers Secondary
3336M0002X Mail Order Pharmacy Suppliers Secondary
3336M0003X Managed Care Organization Pharmacy Suppliers Secondary

Authorized official

Name Edward Moldenhauer
Title Director of Pharmacy Operation
Phone (860) 396-2058

Other identifiers

Identifier Type State Issuer
004129210 Medicaid CT -
0718619 Other - NCPDP PROVIDER IDENTIFICATION NUMBER

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Mashantucket Pequot Tribal?
NPPES lists Edward Moldenhauer (Director of Pharmacy Operation) as the authorized official for this organization.
What is the NPI number for Mashantucket Pequot Tribal?
The NPI for Mashantucket Pequot Tribal is 1003036435, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-04-01.