OrganizationActive
Phs Indian Hospital
NPI 1063549822 · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Red Lake, MN
Provider details
- NPI number
- 1063549822
- Entity type
- Organization
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Jan Thunder, Business Office Manager(218) 679-0148
Specialties & taxonomies
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyPrimary332800000XLicense 2604653 (MN)
Suppliers
Suppliers
- Clinic Pharmacy3336C0002X
Suppliers
- Specialty Pharmacy3336S0011X
Suppliers
Practice location
24670 Hospital Drive
Red Lake, MN 56671
Phone: (218) 679-0173
Fax: (218) 679-0189
Approximate (ZIP-level) locationGet directions
Mailing address
4100 W. 150th St
Cleveland, OH 44135
Other names (DBA / former)
- Doing business as
- Red Lake Indian Hospital Pharmacy
- Doing business as
- Red Lake Indian Hospital Pharmacy
Registry dates
- Enumerated
- 2007-02-28
- Last updated
- 2024-01-19
- Certified
- 2024-01-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.