Organization
RED LAKE KAI SHIN SUD OUTPATIENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE ANDERSEN (REVENUE MANAGER)
(218) 679-1320
Entity
Organization
Contact information
Practice address
705 5TH ST NW STE D, BEMIDJI, MN 56601-2933
(651) 447-3755
Mailing address
PO BOX 566, REDLAKE, MN 56671-0566
(218) 679-1320
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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