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General NPI Number Information
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NPI Number | 1144016957
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Entity Type | Organization
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Legal Business Name | BOIS FORTE RESERVATION TRIBAL COUNCIL
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 305 CHESTNUT ST
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City | VIRGINIA
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State | MN
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Zip | 55792-2523
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Country | US
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Telephone | 218-757-3650
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Fax |
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Provider Business Mailing Address
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Address Line | 5219 SAINT JOHN DR
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City | ORR
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State | MN
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Zip | 55771-8232
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Country | US
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Telephone | 218-757-3650
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Fax | 218-757-0204
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Authorized Official
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Title or Position | PRC AND BILLING SPECIALIST
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Name | CHRISTIE SWANSON
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Credential |
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Telephone | 218-757-3650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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