RED LAKE BAND OF CHIPPEWA INDIANS (NPI# 1972139814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972139814 |
| Entity Type | Organization |
| Organization Name | RED LAKE BAND OF CHIPPEWA INDIANS |
| Practice Address |
34966 605th Ave Warroad MN 56763-9022 |
| Mailing Address |
Po Box 587 Redlake MN 56671-0587 |
| Practice Telephone | 8008158293 |
| Mailing Telephone | 2186791461 |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2020-03-22 |
| Authorized Official Name | ALISHA MARIE GEHLERT (DIRECTOR) |
| Authorized Official Telephone | 2186791461 |
| Is Organization Subpart | Y |
| Parent Organization Name | RED LAKE BAND OF CHIPPEWA INDIANS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| RED LAKE EMERGENCY RESPONSE PROGRAM (W) | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184250029 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 10200 Highway 89, Redlake, MN 56671-2500 | 2020-03-22 |
| 1437785375 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 20595 Center St E, Thief River Falls, MN 56701-8016 | 2020-03-22 |
| 1124214887 | Red Lake Band of Chippewa Indians | Community/Behavioral Health | 15816 Agency Street, Redlake, MN 56671-0472 | 2007-09-17 |
| 1689225351 | Red Lake Band of Chippewa Indians | Case Management | 1900 Chicago Ave, Minneapolis, MN 55404-1903 | 2019-09-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | RED LAKE BAND OF CHIPPEWA INDIANS | 24200 Council St, Redlake, MN 56671 |
| Street Address |
34966 605TH AVE |
| City | WARROAD |
| State | MN |
| Zip Code | 56763-9022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073997094 | Healthstat Onsite Clinic-marvin Companies | Preventive Medicine | 802 State Ave Ne, Warroad, MN 56763 | 2015-07-20 |
| 1063779023 | James R. Thompson | Pharmacist | 310 Lake St, Warroad, MN 56763 | 2012-04-16 |
| 1841463072 | Northern Lights Family Dentistry,pc | Clinic/Center | 603 Emily Ave. Nw, Warroad, MN 56763 | 2008-04-09 |
| 1164564159 | David Alan Verworn | Chiropractor | 203 State Ave S, Warroad, MN 56763 | 2007-02-13 |
| 1093875825 | City of Warroad | Ambulance | 802 Cherne Drive Nw, Warroad, MN 56763 | 2006-12-11 |
| 1861562340 | Roseau/warroad Eye Clinic, P.a. | Optometrist | 301 Lake Street Ne, Warroad, MN 56763 | 2006-11-09 |
| 1669875514 | Roseau Warroad Eye Clinic Pa | Optometrist | 301 Lake Street, Warroad, MN 56763 | 2014-10-07 |
| 1225184450 | Michael Ernest Thiele | Dentist | 301 State Ave Sw, Warroad, MN 56763-0490 | 2007-01-29 |
| 1497745400 | Warroad Family Dentistry, Ltd | Dentist | 307 South State Ave, Warroad, MN 56763-0490 | 2005-10-21 |
| 1700882719 | Lyle Richard Erickson | Chiropractor | 201 Lake St Nw, Suite G, Warroad, MN 56763-2116 | 2005-06-23 |
| Find all providers in zip 56763 | ||||
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184250029 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 10200 Highway 89, Redlake, MN 56671-2500 | 2020-03-22 |
| 1437785375 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 20595 Center St E, Thief River Falls, MN 56701-8016 | 2020-03-22 |
| 1376026153 | Children's Healing Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 25060 Hwy 1 East, Red Lake, MN 56671 | 2018-09-08 |
| 1730696154 | Red Lake Chemical Health Programs | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 14414 Green Lake Road, Redby, MN 56670 | 2018-01-08 |
| 1144765843 | Bois Forte Reservation Tribal Government | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1224 White Pine Cir, Tower, MN 55790 | 2017-01-04 |
| 1629256763 | Fond Du Lac Reservation Business Committee | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 221 W 4th St, Duluth, MN 55806-2719 | 2008-01-31 |
| 1164920963 | Nacc Tribal Health Services | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2018-01-26 |
| 1386152833 | Nacc Medication Assisted Recovery Services | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1213 E Franklin Ave, Minneapolis, MN 55404-2923 | 2018-01-18 |
| 1700394640 | Red Lake Chemical Health Programs | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 15797 Main Ave, Red Lake, MN 56671-0114 | 2018-01-12 |
| 1700064714 | Fond Du Lac Reservation Business Committee | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 2020 Bloomington Ave, Minneapolis, MN 55404-3073 | 2008-02-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.