NPIMap

Organization Active NPI

Bois Forte Reservation Tribal Council

Doing business as Bois Forte Human Services

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nett Lake, MN
National Provider Identifier
1871713321
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 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
Apr 26, 2007
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
Lynette Tahtinen, CPCS
Title
Data & Finance Specialist
Phone
(218) 757-3295

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary

Addresses

Primary practice location

13071 Nett Lake Road
Suite B
Nett Lake, MN 55772

Mailing address

5219 St John Drive
Nett Lake, MN 55772-8232
Phone (218) 757-3295

Other identifiers 1

IdentifierTypeStateIssuer
004218800OtherMN101YA0400X

Other names 1

  • Bois Forte Human Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bois Forte Human Services9 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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1871713321",
    "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": "218-757-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13071 NETT LAKE ROAD",
            "address_2": "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": "2007-04-26",
        "last_updated": "2018-05-15",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "101YA0400X",
            "identifier": "004218800",
            "state": "MN"
        }
    ],
    "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"
        }
    ]
}

Other providers in Nett Lake, 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.