PRAIRIE ISLAND INDIAN COMMUNITY NPI 1821305129

NPI Information

  • NPI: 1821305129
  • Provider Name: PRAIRIE ISLAND INDIAN COMMUNITY
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: PRAIRIE ISLAND COMMUNITY CLINIC
  • CLIA Number: 24D0896392
  • Address: 1158 ISLAND BLVD
    WELCH, MN
    ZIP 55089
  • Phone: (651) 385-4148

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NPI Details

PRAIRIE ISLAND INDIAN COMMUNITY is a clinic center in Welch, MN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PRAIRIE ISLAND INDIAN COMMUNITY NPI is 1821305129. The provider is registered as an organization entity type.
The provider Is Doing Business As Prairie Island Community Clinic.

The provider's business location address is:

1158 ISLAND BLVD
WELCH, MN
ZIP 55089-540
Phone: (651) 385-4148
Fax: (651) 385-4170

The provider's authorized official is Victoria Winfrey .
The authorized official title is Tribal Council President and has the following contact phone number (651) 385-4105.

The CLIA number assigned to this NPI record is 24D0896392 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/8/2010 and was last updated on 9/8/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

What is NPI?

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This page was last updated on: 3/30/2025

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