| NPI | 1376026153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MURIEL DUDLEY Program Director 218-679-1506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2018-09-08 |