| NPI | 1063030419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN MAY Executive Director 218-679-3228 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-13 |