Organization · Type 2 NPI
Red Lake Chemical Health Programs
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Ponemah, MN
Practice location
19195 North Ponemah Road
Ponemah, MN 56666
Fax (218) 554-7325
Mailing address
P.o. Box 114
Red Lake, MN 56671
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | None listed |
| 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.
About NPI 1992213839
Red Lake Chemical Health Programs's National Provider Identifier is 1992213839, issued on Jan 12, 2018. The primary taxonomy on file is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (332800000X), and the practice location is in Ponemah, MN. The record was last updated on Mar 20, 2019.