Organization
SANFORD CLINIC NORTH
Active
Organization
SANFORD CLINIC NORTH
Active
Other names
Sanford Health Gwinner Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTH K LECLERC (VP)
(701) 234-6248
Entity
Organization
Contact information
Practice address
69 HIGHWAY 13 W, GWINNER, ND 58040-4127
(701) 678-2263
(701) 678-2063
Mailing address
720 FOURTH STREET NORTH, FARGO, ND 58122-0605
(701) 234-2000
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12857
—
ND
01
—
1330001
BLUE SHIELD
ND
05
—
5130
—
ND
01
—
CF8850
RAILROAD MEDICARE
ND
Enumeration date
08/01/2006
Last updated
11/27/2023
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