SANFORD CLINIC NORTH (NPI# 1073520003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073520003 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC NORTH |
| Other Organization Name | SANFORD HEALTH FORMAN CLINIC |
| Practice Address |
336 Main Street Forman ND 58032-0184 |
| Mailing Address |
Po Box 2168 Fargo ND 58107-2168 |
| Practice Telephone | 7017243221 |
| Practice Fax Number | 7017243222 |
| Mailing Telephone | 7012342119 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-06-26 |
| Authorized Official Name | TONY LEE MORRISON (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Telephone | 6053288380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | BLUE SHIELD | 1331001 | 01 |
| ND | RAILROAD MEDICARE | CF8850 | 01 |
| ND | 12857 | 05 | |
| ND | 5128 | 05 |
| Other Name | Type Code |
|---|---|
| Sanford Health Forman Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477042372 | Sanford Clinic North | Pharmacy | 1611 Anne St Nw Ste 1, Bemidji, MN 56601-5114 | 2018-05-07 |
| 1386099026 | Sanford Clinic North | Clinic/Center | 625 Demers Ave, East Grand Forks, MN 56721-1833 | 2016-05-02 |
| 1922361716 | Sanford Clinic North | Internal Medicine | 2960 Seter Pkwy, Fargo, ND 58104-8692 | 2012-06-18 |
| 1922303213 | Sanford Clinic North | Clinic/Center | 1245 Washington Avenue, Detroit Lakes, MN 56501-3905 | 2011-01-18 |
| 1437355393 | Sanford Clinic North | Family Medicine | 929 Central Avenue, East Grand Forks, MN 56721 | 2007-06-26 |
| 1124122783 | Sanford Clinic North | Durable Medical Equipment & Medical Supplies | 4000 28th Ave S, Moorhead, MN 56560 | 2006-09-12 |
| 1679677124 | Sanford Clinic North | Durable Medical Equipment & Medical Supplies | 1233 34th St Nw Ste C, Bemidji, MN 56601 | 2006-09-12 |
| 1164439196 | Sanford Clinic North | Clinic/Center | 100 1st Avenue Sw, Suite 2, Lamoure, ND 58458-7311 | 2006-08-02 |
| 1255348280 | Sanford Clinic North | Clinic/Center | 21 Wiley Avenue South, Lidgerwood, ND 58053-4001 | 2006-08-02 |
| 1780690305 | Sanford Clinic North | Clinic/Center | 69 Highway 13 W, Gwinner, ND 58040-4127 | 2006-08-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | SANFORD CLINIC NORTH | 801 Broadway North, Fargo, ND 58122 |
| System for Award Management (SAM) Entities | SANFORD CLINIC NORTH FARGO | 801 Broadway N, Fargo, ND 58102-3641 |
| Street Address |
336 MAIN STREET |
| City | FORMAN |
| State | ND |
| Zip Code | 58032-0184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013926005 | Southeast Therapy Services Inc | Clinic/Center | 336 Main Street, Forman, ND 58032-0184 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265514756 | Sargent County Ambulance Forman | Ambulance | 355 Main St S, Forman, ND 58032 | 2006-10-20 |
| 1255469631 | County of Sargent | Public Health or Welfare | 316 Main Street, Forman, ND 58032 | 2007-02-28 |
| 1497384184 | Rosanne Clare Lohman | Nurse Practitioner | 336 Main St S, Forman, ND 58032-4001 | 2020-04-04 |
| 1427046093 | Nathan Wilbur Schlecht | Pharmacist | 330 Main St S, Forman, ND 58032-4001 | 2005-10-07 |
| 1619453362 | Kelsy Martinson | Pharmacist | 330 Main St S, Forman, ND 58032-4001 | 2018-07-16 |
| 1417945080 | Forman Drug Inc | Pharmacy | 330 Main St S, Forman, ND 58032-4001 | 2005-10-07 |
| 1750799235 | Kari Gilje | Social Worker | 355 Main St S, Suite #7, Forman, ND 58032-4149 | 2014-07-28 |
| 1134536360 | Sargent County Social Services | Case Management | 355 Main St S, Suite #7, Forman, ND 58032-4149 | 2014-07-21 |
| 1518371327 | Darci Weber | Social Worker | 355 Main St S, Forman, ND 58032-4149 | 2014-06-19 |
| 1861470429 | Four Seasons Healthcare Center Inc | Nursing Facility/Intermediate Care Facility | 483 4th St Sw, Forman, ND 58032-4210 | 2006-01-04 |
| Find all providers in zip 58032 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1457963274 | Nelson County Health System | Clinic/Center | 115 South St E, Michigan, ND 58259-4120 | 2020-08-21 |
| 1821637828 | Christian Unity Hospital Corporation | Clinic/Center | 503 Park St W Ste B, Park River, ND 58270-4138 | 2019-12-23 |
| 1023550118 | Northwood Deaconess Health Center | Clinic/Center | 308 Whinery Street, Binford, ND 58416 | 2016-11-07 |
| 1689085797 | Northwood Deaconess Health Center | Clinic/Center | 611 Towner Ave, Larimore, ND 58251 | 2014-05-12 |
| 1043649486 | Jacobson Memorial Hospital Care Center | Clinic/Center | 215 3rd Ave W, Richardton, ND 58652-7109 | 2013-11-06 |
| 1700064599 | Rolla Eye Clinic | Clinic/Center | 118 3rd St. Ne, Rolla, ND 58367-1170 | 2008-02-05 |
| 1891859948 | Nelson County Health System | Clinic/Center | 117 2nd St West, Lakota, ND 58344 | 2006-12-21 |
| 1760570394 | West River Health Services | Clinic/Center | 211 Main Street, Scranton, ND 58653 | 2006-10-10 |
| 1942398508 | West River Health Services | Clinic/Center | 420 Pacific Ave, Mott, ND 58646 | 2006-10-10 |
| 1871691519 | Jacobson Memorial Hospital Care Center | Clinic/Center | 603 East St N, Elgin, ND 58533-7105 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.