# SPIRIT LAKE TRIBE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Spirit Lake Health Center Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265884308
- **Authorized official:** LYNDE MONSON PHARMD (CHIEF PHARMACIST)
- **Authorized official phone:** (701) 766-1612

## Contact information

- **Practice address:** 3883 74TH AVE NE, FORT TOTTEN, ND 58335
- **Practice address phone:** (701) 766-1612
- **Practice address fax:** (701) 766-1625
- **Mailing address:** PO BOX 309, FORT TOTTEN, ND 58335-0309
- **Mailing address phone:** (701) 766-1612
- **Mailing address fax:** (701) 766-1625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | PHAR713 | ND | Yes |

## Other

- **Enumeration date:** 07/12/2016
- **Last updated:** 07/12/2016