| Mille Lacs Band Of Ojibwe Indians | |
|
18562 Minobimaadizi Loop Onamia MN 56359 | |
| (888) 622-4163 | |
| Not Available |
| Full Name | Mille Lacs Band Of Ojibwe Indians |
|---|---|
| Speciality | Clinic/Center |
| Location | 18562 Minobimaadizi Loop, Onamia, Minnesota |
| Authorized Official Name and Position | Nicole Anderson (COMMISSIONER OF HEALTH & HUMAN SERV) |
| Authorized Official Contact | 3205324163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mille Lacs Band Of Ojibwe Indians 18562 Minobimaadizi Loop Onamia MN 56359-3001 Ph: (888) 622-4163 | Mille Lacs Band Of Ojibwe Indians 18562 Minobimaadizi Loop Onamia MN 56359 Ph: (888) 622-4163 |
| NPI Number | 1740357169 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 03/17/2022 |
| Medicare PECOS PAC ID | 5991869471 |
|---|---|
| Medicare Enrollment ID | O20100902000134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740357169 | NPI | - | NPPES |
| 085753000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |