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Organization
MILLE LACS BAND OF OJIBWE INDIANS
Active
Organization
MILLE LACS BAND OF OJIBWE INDIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL ARCHIE MOOSE (COMMISSIONER OF HEALTH)
(320) 532-4750
Entity
Organization
Contact information
Practice address
43500 MIGIZI DRIVE, ONAMIA, MN 56359
(320) 532-4770
(320) 532-4705
Mailing address
43500 MIGIZI DRIVE, ONAMIA, MN 56359
(320) 532-4770
(320) 532-4705
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085753000
—
MN
Enumeration date
03/21/2007
Last updated
03/07/2023
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