National Provider Identifier Database

RED LAKE CHEMICAL HEALTH PROGRAMS
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.


Contact Information

RED LAKE CHEMICAL HEALTH PROGRAMS
15566 DAKOTA AVENUE
REDBY, MN56670
Phone: 218-679-3387
Fax: 218-679-2375
Website:
Specialty Taxonomy Code
* Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for RED LAKE CHEMICAL HEALTH PROGRAMS

NPI Number 1578070991
Legal business name
LBN
RED LAKE CHEMICAL HEALTH PROGRAMS
Authorized official REYNA GONZALEZ-RIVERA - (PROJECT DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 01/08/2018
Last updated 03/20/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • MN Medicaid: 649755100

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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