Healthcare Provider Details

I. General information

NPI: 1598679060
Provider Name (Legal Business Name): WHITE EARTH TRIBAL HEALTH SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40520 COUNTY HIGHWAY 34
OGEMA MN
56569-9612
US

IV. Provider business mailing address

40520 COUNTY HIGHWAY 34
OGEMA MN
56569-9612
US

V. Phone/Fax

Practice location:
  • Phone: 218-983-6375
  • Fax: 218-983-6384
Mailing address:
  • Phone: 218-983-6375
  • Fax: 218-983-6384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: TRACY LHOTKA
Title or Position: CFO
Credential:
Phone: 218-983-4645