SPIRIT LAKE TRIBE; NPI #1740387059

Contact Information

SPIRIT LAKE TRIBE

7686 EPHRIAM HILL ROAD
FORT TOTTEN, ND 58335

Phone: 701-766-4223
Fax: 701-766-4878
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Land Transport	3416L0300X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for SPIRIT LAKE TRIBE

NPI Number 1740387059

LBN Legal business name SPIRIT LAKE TRIBE

Authorized official ELTON GREYWATER - (MANAGER)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/20/2006

Last updated 11/08/2018 - About 8 years ago

Identifiers

ND	License #	142
MN	Medicaid	A610023000
ND	Medicaid	59890
ND	Other	70727	BLUE CROSS PROVIDER

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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