Whalio Doctors

NPI 1063549822

Phs Indian Hospital

Organisation Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Red Lake, MN

Practice location

Address
24670 Hospital Drive, Red Lake, MN 56671
Phone
(218) 679-0173
Fax
(218) 679-0189
Mailing address
4100 W. 150th St Lb: 95419, Cleveland, OH 44135

Authorised official

Name
Jan Thunder
Title
Business Office Manager
Phone
(218) 679-0148

Registered specialties (4)

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Primary
Suppliers Taxonomy 332800000X Licence 2604653 (MN)
Durable Medical Equipment & Medical Supplies
Suppliers Taxonomy 332B00000X
Clinic Pharmacy
Suppliers Taxonomy 3336C0002X
Specialty Pharmacy
Suppliers Taxonomy 3336S0011X

Registry record

NPI
1063549822
Entity type
Organization
NPI issued
28 Feb 2007
Record last updated
19 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.