# SANFORD HEALTH OF NORTHERN MINNESOTA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sanford Health Baudette Eye Center, Sanford Health Baudette Eye Center & Optical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558563668
- **Authorized official:** TONY LEE MORRISON (VICE PRESIDENT, REVENUE CYCLE)
- **Authorized official phone:** (605) 328-8380

## Contact information

- **Practice address:** 103 MAIN ST, SUITE B, BAUDETTE, MN 56623-2475
- **Practice address phone:** (218) 634-1202
- **Mailing address:** PO BOX 5074, SIOUX FALLS, SD 57117-5074
- **Mailing address phone:** (605) 328-6585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 332H00000X | Eyewear Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 06/01/2007
- **Last updated:** 07/02/2020