NPIMap

Organization Active NPI

Red Lake Band of Chippewa Indians

Doing business as Red Lake Emergency Response Program (W)

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Warroad, MN
National Provider Identifier
1972139814
Registry record updated Mar 22, 2020
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 BAND OF CHIPPEWA INDIANS
Doing business as
Red Lake Emergency Response Program (W)
Practice address
34966 605TH Ave
Warroad, MN 56763-9022
Phone
(800) 815-8293
NPI assigned
Mar 22, 2020
Last updated
Mar 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
RED LAKE BAND OF CHIPPEWA INDIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2020

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

Authorized official

Name
Alisha Marie Gehlert
Title
Director
Phone
(218) 679-1461

Specialties & licenses 1

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

Addresses

Primary practice location

34966 605TH Ave
Warroad, MN 56763-9022

Mailing address

PO Box 587
Redlake, MN 56671-0587
Phone (218) 679-1461

Other names 1

  • RED LAKE EMERGENCY RESPONSE PROGRAM (W) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Red Lake Nation Youth Safe Harbor Inc28 organizations share this tax ID, including this one
Part of
Red Lake Nation Youth Safe Harbor Inc

Other organizations with this tax ID 27

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

View all 27

Locations

34966 605th Ave
Warroad, MN 56763
Phone (800) 815-8293

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584835200000",
    "number": "1972139814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "city": "REDLAKE",
            "state": "MN",
            "postal_code": "566710587",
            "telephone_number": "218-679-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34966 605TH AVE",
            "city": "WARROAD",
            "state": "MN",
            "postal_code": "567639022",
            "telephone_number": "800-815-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED LAKE BAND OF CHIPPEWA INDIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RED LAKE BAND OF CHIPPEWA INDIANS",
        "enumeration_date": "2020-03-22",
        "last_updated": "2020-03-22",
        "certification_date": "2020-03-22",
        "status": "A",
        "authorized_official_last_name": "GEHLERT",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "218-679-1461"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RED LAKE EMERGENCY RESPONSE PROGRAM (W)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warroad, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2020; 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.