Ponemah Outpatient is not a DME supplier for medicare equipments and products.
Ponemah Outpatient is a Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy in Ponemah, Minnesota. This pharmacy is owned and operated by Red Lake Chemical Health Programs. This organization is also known as sub part of Ponemah Outpatient. It is located at 19195 North Ponemah Road, Ponemah and it's customer support contact number is 218-554-7425. The authorized person of Ponemah Outpatient is Reyna Cruz Gonzalez-rivera who is Project Director of the pharmacy and his contact number is 218-679-3392. Ponemah Outpatient 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:
Ponemah Outpatient 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:
Ponemah Outpatient
Type:
Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
Location:
19195 North Ponemah Road, Ponemah, Minnesota, 56666
Phone:
218-554-7425
Fax:
218-554-7325
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:
Reyna Cruz Gonzalez-rivera
Position:
Project Director
Contact Number:
218-679-3392
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:
1992213839
Parent Organization:
Ponemah Outpatient
NPI Enumeration Date:
12 Jan, 2018
NPI Last Update On:
20 Mar, 2019
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Ponemah Outpatient are as mentioned below.
Specialization
License Number
State
Status
Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy
Primary
Substance Abuse Rehabilitation Facility
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
1004
Other
Minnesota
Tribal License
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
P.o. Box 114, Red Lake, Minnesota
Zip:
56671
Phone Number:
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Fax Number:
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Patients can reach Ponemah Outpatient at 19195 North Ponemah Road, Ponemah, Minnesota or can call on customer care at 218-554-7425.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.