Phs Indian Hospital
Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
24670 Hospital Drive, Red Lake
Minnesota, 56671
218-679-0173 218-679-0189
Phs Indian Hospital is a Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy in Red Lake, Minnesota. It is located at 24670 Hospital Drive, Red Lake and it's customer support contact number is 218-679-0173. The authorized person of Phs Indian Hospital is Jan Thunder who is Business Office Manager of the pharmacy and his contact number is 218-679-0148. Active license number of Phs Indian Hospital is 2604653 for Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy in Minnesota. Phs Indian Hospital accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Phs Indian Hospital is an Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
Pharmacy Details:
Phs Indian Hospital type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Phs Indian Hospital |
| Type: | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy |
| Location: | 24670 Hospital Drive, Red Lake,
Minnesota, 56671 |
| Phone: | 218-679-0173 |
| Fax: | 218-679-0189 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Jan Thunder |
| Position: | Business Office Manager |
| Contact Number: | 218-679-0148 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1063549822 |
| NPI Enumeration Date: | 28 Feb, 2007 |
| NPI Last Update On: | 19 Jan, 2024 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Phs Indian Hospital are as mentioned below.
| Specialization | License Number | State | Status | |
| Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy | 2604653 | Minnesota | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Clinic Pharmacy | | | Secondary | |
| Specialty Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2046533 | Other | | Pk |
| 476753500 | Medicaid | Minnesota | |
Medicare Enrollment:
Phs Indian Hospital is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 4789598731 | O20120626000228 | Phs Indian Hospital | DME SUPPLIER - PHARMACY |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 4100 W. 150th St, Lb: 95419
Cleveland, Ohio |
| Zip: | 44135 |
| Phone Number: | -- |
Patients can reach Phs Indian Hospital at
24670 Hospital Drive, Red Lake, Minnesota or can
call on customer care at 218-679-0173.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.