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MASHKIKI WAAKAAIGAN PHARMACY
NPI 1700064714
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Minneapolis, MN

Active since February 01, 2008
2020 BLOOMINGTON AVE, MINNEAPOLIS, MN 55404(612) 871-1989(612) 222-3463 Get Directions Write a Review

NPPES record last updated: October 12, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mashkiki Waakaaigan Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MASHKIKI WAAKAAIGAN PHARMACY (NPI 1700064714) is a healthcare organization registered as an indian health service/tribal/urban indian health (i/t/u) pharmacy in Minneapolis, Minnesota and active in the NPI registry since February 2008. The organization lists Marilyn Grover, Associate Director, as its authorized official.

NPPES Registry Identity

NPI1700064714
Entity TypeOrganization
Primary Taxonomy332800000X
Legal Business NameFOND DU LAC RESERVATION BUSINESS COMMITTEE
Location Address2020 BLOOMINGTON AVEMinneapolis, MN 55404-3073
Mailing Address927 Trettel Lane, Fond Du Lac Human Services DivisionCloquet, MN 55720 · (218) 879-1227 · Fax (218) 878-3755
Phone(612) 871-1989
Fax(612) 222-3463
Organization SubpartYesParent: Fond Du Lac Human Services Division
Authorized OfficialMarilyn GroverAssociate Director · (218) 878-2101
Enumeration DateFebruary 1, 2008
Last NPPES UpdateOctober 12, 2017
✔ NPI 1700064714 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
Taxonomy Code332800000X
License✔ Licensed in MN · 263031
Definition

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.

2020 BLOOMINGTON AVE, Minneapolis, MN 55404
Open in Google Maps ↗

Other Names 1

Doing Business AsMashkiki Waakaaigan Pharmacy

Other Identifiers 4

Medicare NSC5985000001MN
Medicare UPINNPP000MN
Other2428349MN · Ncpdp
Medicaid666815100MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2272073

Fond Du Lac Home Care · Cloquet, MN
Active · expires Nov 14, 2026
CLIA Number24D2272073
Laboratory TypeHome Health Agency
Certificate Effective DateNovember 15, 2024
Certificate Expiration DateNovember 14, 2026
Laboratory DirectorHaley Pfisthner
Laboratory Phone(218) 878-3848
Laboratory LocationFond Du Lac Home Care1571 Airport Road, Cloquet, MN 55720
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNETH REED MCMILLAN MD
General Practice
2020 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 813-1610
MRS. SUE ANNE SCHABER RN
Registered Nurse
2020 BLOOMINGTON AVE, HEALTH STAR
MINNEAPOLIS, MN 55404
Hennepin County (612) 871-3700
OVERCOMERS OUTREACH MINISTRIES
Health Maintenance Organization
2020 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 871-1208
MRS. JO ELLEN HEMINK RPH
Pharmacist
2020 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 871-1989

Frequently Asked Questions

What is FOND DU LAC RESERVATION BUSINESS COMMITTEE's NPI number?

The NPI number assigned to this healthcare provider is 1700064714, enumerated as an "organization" on February 01, 2008.

Where is the provider located?

The provider is located at 2020 BLOOMINGTON AVE MINNEAPOLIS, MN 55404 and the phone number is (612) 871-1989.

What is the provider's specialty?

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy with taxonomy code 332800000X.

What insurance does FOND DU LAC RESERVATION BUSINESS COMMITTEE accept?

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter from. Please consult your insurance carrier or call the provider to verify.