Provider Demographics
NPI:1194754382
Name:DEPARTMENT OF HEALTH & HUMAN SERVICES PHS IHS
Entity type:Organization
Organization Name:DEPARTMENT OF HEALTH & HUMAN SERVICES PHS IHS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:218-335-3200
Mailing Address - Street 1:425 7TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CASS LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56633-3360
Mailing Address - Country:US
Mailing Address - Phone:218-335-3200
Mailing Address - Fax:218-335-3204
Practice Address - Street 1:425 7TH ST NW
Practice Address - Street 2:
Practice Address - City:CASS LAKE
Practice Address - State:MN
Practice Address - Zip Code:56633-3360
Practice Address - Country:US
Practice Address - Phone:218-335-3200
Practice Address - Fax:218-335-3204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN241358Medicare Oscar/Certification
MN24Z358Medicare Oscar/Certification
MNHSZ183Medicare PIN