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Mashantucket Pequot Tribal

Mail Order Pharmacy in Mashantucket, CT · enumerated 2010 · authorized official Edward Moldenhauer, Director of Pharmacy Operation.

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

National Provider Identifier

1578886461

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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, Bldg 1, Mashantucket, CT, 06338
Phone (860) 396-6438
Fax (800) 779-6329
Enumeration date Mar 5, 2010
Last updated in NPPES Apr 1, 2011

Taxonomy & classification

3336M0002X Mail Order Pharmacy Suppliers · License 285960015 (CT) Primary

Authorized official

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

Other identifiers

Identifier Type State Issuer
0721820 Other - NCPDP PROVIDER IDENTIFICATION NUMBER
004129210 Medicaid CT -

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

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2011-04-01. Verify at npiregistry.cms.hhs.gov.
Where is Mashantucket Pequot Tribal located?
The practice location on file with NPPES is in Mashantucket, CT.

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