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Organization
SANFORD MEDICAL CENTER FARGO
Active
Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Health Detroit Lakes Eye Center & Optical
Organization subpart
No
Provider details
NPI number
Authorized official
TONY LEE MORRISON (VP, FINANCE)
(605) 328-8380
Entity
Organization
Contact information
Practice address
1234 WASHINGTON AVE STE A, DETROIT LAKES, MN 56501-3906
(218) 846-2000
(701) 234-2045
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
(701) 234-2045
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4C334BE
MNBC
—
01
—
801770
NDBC
—
Enumeration date
12/29/2006
Last updated
08/02/2024
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