Organization · Type 2 NPI

Bois Forte Reservation Tribal Government

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Nett Lake, MN

NPI number 1972666469 Active

Practice location

5219 St John Dr
Nett Lake, MN 55772

Call (218) 757-3650 Map

Fax (218) 757-0234

Mailing address

5219 Saint John Dr
Orr, MN 55771-8232

Specialties and licenses

Taxonomy	Code	License
Health Service Clinic/Center	261QH0100X	261489-2 (MN)
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Primary	332800000X	None listed

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.

Other indian health service/tribal/urban indian health (i/t/u) pharmacy providers in Nett Lake

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NPI record

NPI: 1972666469
Entity type: Organization (Type 2)
Issued: Dec 18, 2006
Last updated: Feb 25, 2026
Status: Active
Subpart: Yes of Bois Forte Reservation Tribal Government

Other names

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Bois Forte Medical Clinic Pharmacy · doing business as
Bois Forte Medical Clinic Pharmacy · doing business as

Authorized official

Christie Swanson
PRC and Billing Specialist
(218) 757-3650

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1972666469

Bois Forte Reservation Tribal Government's National Provider Identifier is 1972666469, issued on Dec 18, 2006. The primary taxonomy on file is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (332800000X), and the practice location is in Nett Lake, MN. The record was last updated on Feb 25, 2026.