NPIMap

Organization Active NPI

Nacc Medication Assisted Recovery Services

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Minneapolis, MN
National Provider Identifier
1386152833
Registry record updated Jan 18, 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
NACC MEDICATION ASSISTED RECOVERY SERVICES
Practice address
1213 E Franklin Ave
Minneapolis, MN 55404-2923
Phone
(612) 872-8086
Fax
(612) 872-8547
NPI assigned
Jan 18, 2018
Last updated
Jan 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Authorized official

Name
Sam Strong
Title
Economic Development Director
Phone
(218) 679-3341

Specialties & licenses 1

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

Addresses

Primary practice location

1213 E Franklin Ave
Minneapolis, MN 55404-2923

Mailing address

1213 E Franklin Ave
Minneapolis, MN 55404-2923
Phone (612) 872-8086

Other identifiers 1

IdentifierTypeStateIssuer
2001OtherTRIBAL LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Red Lake Nation Youth Safe Harbor Inc28 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

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516233600000",
    "number": "1386152833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 E FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042923",
            "telephone_number": "612-872-8086",
            "fax_number": "612-872-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 E FRANKLIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042923",
            "telephone_number": "612-872-8086",
            "fax_number": "612-872-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACC MEDICATION ASSISTED RECOVERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A",
        "authorized_official_last_name": "STRONG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "ECONOMIC DEVELOPMENT DIRECTOR",
        "authorized_official_telephone_number": "218-679-3341"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIBAL LICENSE",
            "identifier": "2001",
            "state": null
        }
    ],
    "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 18, 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.