NPIMap

Organization Active NPI

Bois Forte Reservation Tribal Government

Doing business as New Moon

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Tower, MN
National Provider Identifier
1144765843
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
BOIS FORTE RESERVATION TRIBAL GOVERNMENT
Doing business as
New Moon
Practice address
1224 White Pine Cir
Tower, MN 55790
Phone
(218) 757-3131
NPI assigned
Jan 4, 2017
Last updated
May 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pamela Hughes
Title
Manager
Phone
(218) 757-3295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary

Addresses

Primary practice location

1224 White Pine Cir
Tower, MN 55790

Mailing address

5219 Saint John Dr
Orr, MN 55771-8232
Phone (218) 757-3295

Other names 1

  • New Moon Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vermilion Pharmacy9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1144765843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 SAINT JOHN DR",
            "city": "ORR",
            "state": "MN",
            "postal_code": "557718232",
            "telephone_number": "218-757-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 WHITE PINE CIR",
            "city": "TOWER",
            "state": "MN",
            "postal_code": "55790",
            "telephone_number": "218-757-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOIS FORTE RESERVATION TRIBAL GOVERNMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "218-757-3295"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Moon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Moon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tower, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.