NPIMap

Organization Active NPI

Mino Bimaadiziwin Health Clinic

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Minneapolis, MN
National Provider Identifier
1144809369
Registry record updated Jan 3, 2022
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
MINO BIMAADIZIWIN HEALTH CLINIC
Practice address
2115 Cedar Ave S
Minneapolis, MN 55404
Phone
(218) 679-1320
NPI assigned
Apr 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Authorized official

Name
Charlene Andersen
Title
Revenue Generating Supervisor
Phone
(218) 679-1320

Specialties & licenses 1

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

Addresses

Primary practice location

2115 Cedar Ave S
Minneapolis, MN 55404

Mailing address

2115 Cedar Ave S
Minneapolis, MN 55404-3102
Phone (612) 436-0156

National Provider Directory

National Provider Directory
Tax ID family
Red Lake Chemical Health Programs Outpatient28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

2115 Cedar Ave S
Minneapolis, MN 55404
Phone (218) 679-1320

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1144809369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 CEDAR AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043102",
            "telephone_number": "612-436-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 CEDAR AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "218-679-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINO BIMAADIZIWIN HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "REVENUE GENERATING SUPERVISOR",
        "authorized_official_telephone_number": "218-679-1320"
    },
    "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": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.