PONEMAH CLINIC; NPI #1760680300

Contact Information

PONEMAH CLINIC

HWY 1
BOX 497
RED LAKE, MN 56671

Phone: 218-679-3912
Fax: 218-679-0181
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Health Service	261QH0100X

Indicates primary specialty

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NPI Profile & details for PONEMAH CLINIC

NPI Number	`1760680300`
LBN Legal business name	PONEMAH CLINIC
Authorized official	KATHLEEN DUDLEY - (MEDICAL STAFF COOR.)
Entity	Organization
Organization subpart ¹	No
Enumeration date	07/05/2007
Last updated	08/14/2008 - About 18 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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