FOND DU LAC RESERVATION BUSINESS COMMITTEE (NPI# 1629256763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629256763 |
| Entity Type | Organization |
| Organization Name | FOND DU LAC RESERVATION BUSINESS COMMITTEE |
| Other Organization Name | FOND DU LAC CAIR PHARMACY |
| Practice Address |
221 W 4th St Duluth MN 55806-2719 |
| Mailing Address |
Fond Du Lac Human Serv Division 927 Trettel Lane Cloquet MN 55720 |
| Practice Telephone | 2182794142 |
| Practice Fax Number | 2182794077 |
| Mailing Telephone | (218) 829-1227 |
| Mailing Fax Number | 2188782188 |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2017-09-11 |
| Authorized Official Name | MARILYN GROVER (ASSOCIATE DIRECTOR) |
| Authorized Official Telephone | 2188791227 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 260913 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2047381 | 01 | |
| MN | 66815100 | 05 |
| Other Name | Type Code |
|---|---|
| FOND DU LAC CAIR PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134426778 | Fond Du Lac Reservation Business Committee | Assisted Living Facility | 1571 Airport Road, Fond Du Lac Assisted Living, Cloquet, MN 55720 | 2011-02-17 |
| 1326053166 | Fond Du Lac Reservation Business Committee | Durable Medical Equipment & Medical Supplies | 927 Trettle Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2006-07-30 |
| 1053772087 | Fond Du Lac Reservation Business Committee | Clinic/Center | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2016-03-18 |
| 1346501392 | Fond Du Lac Reservation Business Committee | Pharmacy | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2012-06-06 |
| 1225335862 | Fond Du Lac Reservation Business Committee | Clinic/Center | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2011-02-17 |
| 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 |
| Street Address |
221 W 4TH ST |
| City | DULUTH |
| State | MN |
| Zip Code | 55806-2719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629593546 | Tricia Lynn Voss | Pharmacist | 221 W 4th St, Duluth, MN 55806-2719 | 2017-08-11 |
| 1306376850 | Janis A Greene | Social Worker | 221 W 4th St, Duluth, MN 55806-2719 | 2017-06-18 |
| 1023328853 | Stephanie Jo Anderson | Pharmacist | 221 W 4th St, Duluth, MN 55806-2719 | 2010-10-14 |
| 1619117066 | Shari Marie Gentilini | Pharmacist | 221 W 4th St, Duluth, MN 55806-2719 | 2009-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023339389 | Community Connection of Mn, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2701 W. Superior St., Suite 101, Duluth, MN 55806 | 2010-06-21 |
| 1902998875 | Stephen Thomas Hero | Dentist | 2016 W Superior Street, Duluth, MN 55806 | 2006-09-29 |
| 1851906697 | Tadd William Berg | Specialist/Technologist | 2415 W 9th St, Duluth, MN 55806-1150 | 2020-09-09 |
| 1144787375 | Andrew Eric Norris | Specialist/Technologist | 2316 W 9th St Apt 1, Duluth, MN 55806-1229 | 2019-02-24 |
| 1013187855 | John Peter Vorderbruggen | Technician/Technologist | 901 N 23rd Ave W, Duluth, MN 55806-1244 | 2008-03-07 |
| 1891017638 | Jesse Dykhuis | Doula | 3304 Vernon St, Duluth, MN 55806-1327 | 2010-02-21 |
| 1619063039 | Andrew John Vasil | General Practice | 623 Pacific Ave, Duluth, MN 55806-1336 | 2006-10-04 |
| 1952688871 | Megan Rock | Dental Hygienist | 2720 W 7th St, Duluth, MN 55806-1345 | 2011-11-06 |
| 1265778005 | Jeremy Lee Walton | Occupational Therapist | 514 Winnipeg Ave, Duluth, MN 55806-1449 | 2012-12-26 |
| 1790147049 | Kathleen Ann Miller | Occupational Therapy Assistant | 2963 Exeter St, Duluth, MN 55806-1450 | 2016-03-25 |
| Find all providers in zip 55806 | ||||
| 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 |
|---|---|---|---|---|
| 1972139814 | Red Lake Band of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 34966 605th Ave, Warroad, MN 56763-9022 | 2020-03-22 |
| 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 |
| 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.