Red Lake Indian Hospital Pharmacy

LBN: Phs Indian Hospital
Red Lake Indian Hospital Pharmacy is an health care organization with primary practice located at 24670 Hospital Drive , Red Lake MN 56671. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Clinic Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty. Phs Indian Hospital can be contacted via phone (218) 679-0173, or through Thunder, Jan via phone (218) 679-0148.

Contact Information

Primary practice address
24670 Hospital Drive Red Lake MN 56671
Phone: (218) 679-0173
Fax: (218) 679-0189
Website:
Map and Directions
Authorized official contact:
Name: Thunder, Jan
Phone: (218) 679-0148

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X 2604653 Minnesota
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1063549822
LBN Legal business name Phs Indian Hospital
DBA Doing business as Red Lake Indian Hospital Pharmacy
Authorized official Thunder, Jan
Entity Organization
Organization subpart 1 No
Enumeration date Feb 28th, 2007
Last updated Jan 19th, 2024 - about 11 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063549822 NPPES
Other 2046533 PK
MEDICAID 476753500 PK

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