Organization
MINO BIMAADIZIWIN HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE ANDERSEN (REVENUE GENERATING SUPERVISOR)
(218) 679-1320
Entity
Organization
Contact information
Practice address
2115 CEDAR AVE S, MINNEAPOLIS, MN 55404
(218) 679-1320
Mailing address
2115 CEDAR AVE S, MINNEAPOLIS, MN 55404-3102
(612) 436-0156
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
01/03/2022
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