| Organization Name: | WHITE EARTH BAND OF CHIPPEWA |
| NPI Number: | 1033129556 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIM HOGLUND (BILLING MANAGER) |
| Mailing Address: | 26246 Crane Rd White Earth |
| State: | MN US |
| Postal Code: | 565919998 |
| Phone Number: | 2189833285 |
| Fax Number: | 2189834299 |
| NPI Enumeration Date: | 08/08/2006 |
| NPI Last Update Date: | 01/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 0354 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |