Bois Forte Reservation Tribal Government
LBN: Bois Forte Medical Clinic
Bois Forte Reservation Tribal Government is an health care organization with primary practice located at 5219 St John Dr , Nett Lake MN 55772. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Health Service, Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty.
Bois Forte Medical Clinic can be contacted via phone (218) 757-3650, or through Corradi, Julie via phone (218) 757-3650.
Contact Information
Primary practice address
5219 St John Dr
Nett Lake MN 55772
Phone: (218) 757-3650
Fax: (218) 757-0234
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Health Service | 261QH0100X | 261489-2 | Minnesota |
| Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X |
Profile Details
| NPI number | 1972666469 |
|---|---|
| LBN Legal business name | Bois Forte Medical Clinic |
| DBA Doing business as | Bois Forte Reservation Tribal Government |
| Authorized official | Corradi, Julie PHARMACIST |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Dec 18th, 2006 |
| Last updated | May 16th, 2018 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972666469 | NPPES |
| Minnesota | Other | 63G35BO | BCBS |
| Minnesota | Other | 0104492 | BCBS |
| Minnesota | MEDICAID | 177515400 | BCBS |
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