BOIS FORTE RESERVATION TRIBAL COUNCIL (NPI# 1750498218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750498218 |
| Entity Type | Organization |
| Organization Name | BOIS FORTE RESERVATION TRIBAL COUNCIL |
| Practice Address |
5219 Saint John Dr Orr MN 55771 |
| Mailing Address |
5219 Saint John Dr Orr MN 55771-8232 |
| Practice Telephone | 2187573650 |
| Mailing Telephone | 2187573650 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2018-05-16 |
| Authorized Official Name | CATHERINE CHAVERS (TRIBAL CHAIRMAN) |
| Authorized Official Telephone | 2187573661 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 341600000X | Ambulance | 0328 | MN | Transportation Services |
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS | 63G31BO | 01 |
| MN | 903867100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255815387 | Bois Forte Reservation Tribal Council | Non-emergency Medical Transport (VAN) | 5344 Lake Shore Dr, Nett Lake, MN 55772-1200 | 2018-09-25 |
| 1538371117 | Bois Forte Reservation Tribal Council | Clinic/Center | 1195 County Road 77, Tower, MN 55790 | 2007-05-04 |
| 1871713321 | Bois Forte Reservation Tribal Council | Clinic/Center | 13071 Nett Lake Road, Suite B, Nett Lake, MN 55772 | 2007-04-26 |
| 1649270901 | Bois Forte Reservation Tribal Council | Community/Behavioral Health | 13071 Nett Lake Road, Suite B, Nett Lake, MN 55772 | 2005-07-28 |
| Street Address |
5219 SAINT JOHN DR |
| City | ORR |
| State | MN |
| Zip Code | 55771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497373070 | Melissa Hawk | Registered Nurse | 5219 Saint John Dr, Orr, MN 55771-8232 | 2020-07-09 |
| 1265058903 | Bois Forte Reservation Tribal Government | Pharmacy | 5219 Saint John Dr, Orr, MN 55771-8232 | 2020-06-18 |
| 1225536592 | Brandon Mark Anderson | Registered Nurse | 5219 Saint John Dr, Orr, MN 55771-8232 | 2018-01-31 |
| 1285153007 | Paul Rasmussen | Nurse Practitioner | 5219 Saint John Dr, Orr, MN 55771-8232 | 2017-09-13 |
| 1316482672 | Wendy Drift | Social Worker | 5219 Saint John Dr, Orr, MN 55771-8232 | 2016-12-22 |
| 1174834709 | Crystal Lee Lobe | Nurse Practitioner | 5219 Saint John Dr, Orr, MN 55771-8232 | 2010-06-29 |
| 1588735856 | Jane Marie Lawrenz | Psychologist | 5219 Saint John Dr, Orr, MN 55771-8232 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760494611 | Lance E Hardwig | Physician Assistant | 13071 Nett Lake Rd., Nett Lake, MN 55771 | 2006-08-12 |
| 1043468853 | Bois Forte Health Services | Case Management | 13071 Nett Lake Road, Nett Lake, MN 55771 | 2008-09-04 |
| 1437181179 | Charles R Helleloid | Family Medicine | 13071 Nett Lake Rd, Orr, MN 55771-8111 | 2006-07-06 |
| 1134308448 | Raymond Lawrence Hawk | Physician Assistant | 13071 Nett Lake Rd, Orr, MN 55771-8111 | 2007-11-02 |
| 1265512420 | Michael Todd Rowlette | Dentist | 13071 Nett Lake Rd, Orr, MN 55771-8111 | 2006-10-16 |
| 1932331725 | Arlene R Sipola | Adult Companion | 4420 Brandt Rd, Orr, MN 55771-8358 | 2009-08-13 |
| 1205937604 | Daniel J Lofgren | Psychologist | 10574 Willow River Rd, Orr, MN 55771-9055 | 2006-09-26 |
| 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 |
| 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 |
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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.