OrganizationActive
Fond Du Lac Reservation Business Committee
NPI 1700064714 · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Minneapolis, MN
Provider details
- NPI number
- 1700064714
- Entity type
- Organization
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
- Parent organization
- Fond Du Lac Human Services Division
- Organization subpart
- Yes
- Authorized official
- Marilyn Grover, Associate Director(218) 878-2101
- License
- 263031 (MN)
Specialties & taxonomies
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyPrimary332800000XLicense 263031 (MN)
Suppliers
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2020 Bloomington Ave
Minneapolis, MN 55404-3073
Phone: (612) 871-1989
Fax: (612) 222-3463
Street-level locationGet directions
Mailing address
927 Trettel Lane
Cloquet, MN 55720
Other names (DBA / former)
- Doing business as
- Mashkiki Waakaaigan Pharmacy
Registry dates
- Enumerated
- 2008-02-01
- Last updated
- 2017-10-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.