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Organization
BOIS FORTE RESERVATION TRIBAL COUNCIL
Active
Organization
BOIS FORTE RESERVATION TRIBAL COUNCIL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE CHAVERS (TRIBAL CHAIRMAN)
(218) 757-3661
Entity
Organization
Contact information
Practice address
5219 SAINT JOHN DR, ORR, MN 55771
(218) 757-3650
Mailing address
5219 SAINT JOHN DR, ORR, MN 55771-8232
(218) 757-3650
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
341600000X
Ambulance
0328
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63G31BO
BCBS
MN
05
—
903867100
—
MN
Enumeration date
08/23/2006
Last updated
05/16/2018
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