Organization
PHS INDIAN HOSPITAL
Active
Other names
PHS INDIAN HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN COOK DR. (CEO)
(218) 679-0107
Entity
Organization
Contact information
Practice address
HWY 1 HOSPITAL DR, BOX 497, RED LAKE, MN 56671-0497
(218) 679-3912
(218) 679-0181
Mailing address
HWY 1 HOSPITAL DR, BOX 497, RED LAKE, MN 56671
(218) 679-3912
(218) 679-0181
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25F45RE
BC/BS OF MN
MN
05
—
476753500
—
MN
01
—
5A54HPU
BC/BS OF MN
MN
Enumeration date
06/14/2006
Last updated
04/16/2026
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