Organization
SANFORD CLINIC NORTH
Active
Parent organization
SANFORD CLINIC NORTH
Other names
Sanford Pharmacy Bemidji 340B
Organization subpart
Yes
Provider details
NPI number
Legal business name
SANFORD CLINIC NORTH
Authorized official
CAROLYN TUTTLE (VICE PRESIDENT, REVENUE CYCLE)
(605) 328-8384
Entity
Organization
Contact information
Practice address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5265
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2414504
NCPDP
—
Enumeration date
05/07/2018
Last updated
05/07/2018
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