RED LAKE INDIAN HOSPITAL PHARMACY – Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, NPI 1063549822
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for RED LAKE INDIAN HOSPITAL PHARMACY
BEMIDJI AREA RED LK
3136 SOLUTIONS CENTER
CHICAGO, IL 606773001
Phone:
Type: Mailing
HWY 1
RED LAKE, MN 56671
Phone: (218) 679-0173
Fax: (218) 679-0189
Type: Location
4100 W. 150TH ST
LB: 95419
CLEVELAND, OH 44135
Phone:
Type: Mailing
24670 HOSPITAL DRIVE
RED LAKE, MN 56671
Phone: (218) 679-0173
Fax: (218) 679-0189
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-06-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-10-31 (591 days ago).
Enrollment records
1
Earliest due date
2024-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20120626000228 | O | Pharmacy | MN | 2024-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60677)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.