NPIMap

Organization Active NPI

Red Lake Chemical Health Programs

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Redby, MN
National Provider Identifier
1730696154
Registry record updated Jan 8, 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
RED LAKE CHEMICAL HEALTH PROGRAMS
Practice address
14414 Green Lake Road
Redby, MN 56670
Phone
(218) 679-3868
Fax
(218) 679-3398
NPI assigned
Jan 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Authorized official

Name
Reyna Cruz Gonzalez-Rivera
Title
Project Director
Phone
(218) 679-3392

Specialties & licenses 1

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

Addresses

Primary practice location

14414 Green Lake Road
Redby, MN 56670

Mailing address

P.O. Box 114
Red Lake, MN 56671

Other names 1

  • Red Lake Group Home Former legal business name

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

NPI Registry JSON

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1730696154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 114",
            "city": "RED LAKE",
            "state": "MN",
            "postal_code": "56671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14414 GREEN LAKE ROAD",
            "city": "REDBY",
            "state": "MN",
            "postal_code": "56670",
            "telephone_number": "218-679-3868",
            "fax_number": "218-679-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED LAKE CHEMICAL HEALTH PROGRAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ-RIVERA",
        "authorized_official_first_name": "REYNA",
        "authorized_official_middle_name": "CRUZ",
        "authorized_official_title_or_position": "PROJECT DIRECTOR",
        "authorized_official_telephone_number": "218-679-3392"
    },
    "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": "Red Lake Group Home",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Redby, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.