Organization
BOIS FORTE RESERVATION TRIBAL GOVERNMENT
Active
Parent organization
BOIS FORTE RESERVATION TRIBAL GOVERNMENT
Other names
Bois Forte Medical Clinic Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOIS FORTE RESERVATION TRIBAL GOVERNMENT
Authorized official
CHRISTIE SWANSON (PRC AND BILLING SPECIALIST)
(218) 757-3650
Entity
Organization
Contact information
Practice address
5219 ST JOHN DR, NETT LAKE, MN 55772
(218) 757-3650
(218) 757-0234
Mailing address
5219 SAINT JOHN DR, ORR, MN 55771-8232
(218) 757-3650
(218) 757-0234
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
261489-2
MN
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0104492
MEDICA
MN
05
—
177515400
—
MN
01
—
63G35BO
BCBS
MN
Enumeration date
12/18/2006
Last updated
02/25/2026
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