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FQHC638537A Prairie Island Indian Community (Active)
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Main Details
Name
Prairie Island Indian Community
Subdivision Name
Prairie Island Health Center
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638537A
Additional Details
Current Program Status
Active
Registration Date
4/6/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/25/2017
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Prairie Island Indian Community
Tom Gnotke, Finance Director
(651) 385-4111
Primary Contact
Prairie Island Indian Community
Kathy A LeMieux, Health Director
(651) 385-4187
Addresses
Street Address
5636 Sturgeon Lake Rd
Welch, MN 55089
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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June 2025
June 2025
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