Bois Forte Reservation Tribal Council

Primary specialty

Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X

Legal business name

BOIS FORTE RESERVATION TRIBAL COUNCIL

Doing business as

Bois Forte Human Services

Practice address

13071 Nett Lake Road, Suite B
Nett Lake, MN 55772

Phone

(218) 757-3295

Fax

(218) 757-0234

NPI assigned

Jul 28, 2005

Organization subpart

No

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

Authorized official

Name

Lynette Tahtinen, CPCS

Title

Data & Finance Specialist

Phone

(218) 757-3295

Specialties & licenses 2

Addresses

Other names 1

• Bois Forte Human Services Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Bois Forte Reservation Tribal Government

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nett Lake, MN
  • NPI 1073530150

  O20031105000284

  Same enrollment
• Bois Forte Reservation Tribal Government

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nett Lake, MN
  • NPI 1972666469

  O20031105000284

  Same enrollment
• Vermilion Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Tower, MN
  • NPI 1437691417

  O20031105000284

  Same enrollment

Locations

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1649270901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 ST JOHN DRIVE",
            "city": "NETT LAKE",
            "state": "MN",
            "postal_code": "557728232",
            "telephone_number": "218-757-3295",
            "fax_number": "218-757-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13071 NETT LAKE ROAD, SUITE B",
            "city": "NETT LAKE",
            "state": "MN",
            "postal_code": "55772",
            "telephone_number": "218-757-3295",
            "fax_number": "218-757-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOIS FORTE RESERVATION TRIBAL COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "TAHTINEN",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "DATA & FINANCE SPECIALIST",
        "authorized_official_telephone_number": "218-757-3295",
        "authorized_official_credential": "CPCS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "251S00000X-COMMUNITY",
            "primary": false
        },
        {
            "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": "Bois Forte Human Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bois Forte Human Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bois Forte Health Services
• Bois Forte Human Services
• Bois Forte Reservation Tribal Council
• Bois Forte Reservation Tribal Council
• Bois Forte Reservation Tribal Government
• Bois Forte Reservation Tribal Government
• Melissa Joan Grzybowski
• Lance E Hardwig, P.A,

• Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Nett Lake, MN
• Providers in Nett Lake, MN by specialty
• Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.