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Bois Forte Medical Clinic
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Nett Lake, Minnesota
NPI 1972666469

Bois Forte Medical Clinic is a Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy based in Nett Lake, MN. Bois Forte Medical Clinic practices in Nett Lake, MN. The NPI Number for Bois Forte Medical Clinic is 1972666469 and holds a License No. 261489-2 (Minnesota).

The current practice location address for Bois Forte Medical Clinic is 5219 St John Dr, Nett Lake, MN and can be reached out via phone at 218-757-3650 and via fax at 218-757-0234.

Location: 5219 St John Dr, Nett Lake, MN, 55772-8111
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1972666469
Provider Name
Bois Forte Medical Clinic
Credential
Provider Entity Type
Organization
Address
5219 St John Dr, Nett Lake, MN, 55772-8111
Phone Number
218-757-3650
Fax Number
218-757-0234
Provider Enumeration Date
12/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
63G35BO 01 MN BCBS
0104492 01 MN MEDICA
177515400 05 MN
institution
Provider Business Practice Location Address Details
Address
5219 St John Dr
City
Nett Lake
State
Minnesota
Zip
55772
Phone Number
218-757-3650
Fax Number
218-757-0234
person
Provider Business Mailing Address Details
Address
5219 St John Dr
City
Nett Lake
State
Minnesota
Zip
55772
Phone Number
218-757-3650
Fax Number
218-757-0234
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
261QH0100X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
261489-2 (Minnesota)
Definition
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.
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