SANFORD CLINIC NORTH (NPI# 1124184403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124184403 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC NORTH |
| Other Organization Name | SANFORD HEALTH DETROIT LAKES EYE CENTER & OPTICAL |
| Practice Address |
1245 Washington Ave Detroit Lakes MN 56501-3905 |
| Mailing Address |
Po Box 2168 Fargo ND 58107-2168 |
| Practice Telephone | 2188462000 |
| Practice Fax Number | 7012342045 |
| Mailing Telephone | 7012342119 |
| Mailing Fax Number | 7012342045 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-06-29 |
| 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 | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MNBC | 4C334BE | 01 | |
| NDBC | 801770 | 01 |
| Other Name | Type Code |
|---|---|
| Sanford Health Detroit Lakes Eye Center & Optical | 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 |
| 1073520003 | Sanford Clinic North | Clinic/Center | 336 Main Street, Forman, ND 58032-0184 | 2006-08-02 |
| 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 |
| 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 |
1245 WASHINGTON AVE |
| City | DETROIT LAKES |
| State | MN |
| Zip Code | 56501-3905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871582643 | Mark David Lindquist | Family Medicine | 1245 Washington Ave, Detroit Lakes, MN 56501 | 2005-10-14 |
| 1467013896 | Jessica Rosenau | Physical Therapist | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2019-06-26 |
| 1538513155 | Molly Marie Anderson | Family Medicine | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2016-04-20 |
| 1073975462 | Max Disse | Dermatology | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2016-03-24 |
| 1578950887 | Mathew Malek | Surgery | 1245 Washington Ave, Detroit Lakes, MN 56501-3923 | 2015-04-24 |
| 1811391915 | Kathyrn J Moe | Nutritionist | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2014-10-17 |
| 1740683796 | Tina Mcdonald | Occupational Therapist | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2014-10-06 |
| 1457799652 | Leah M Hochstein | Nurse Practitioner | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2013-06-10 |
| 1508109661 | Mary Jane Richter | Audiologist | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2013-03-27 |
| 1982941860 | Angela M Weaver | Occupational Therapist | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2013-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1194215830 | Jordan James Reese | Registered Nurse | 1295 Bay Ridge Dr, Detroit Lakes, MN 56501 | 2018-05-17 |
| 1992179386 | Compassion House | Substance Abuse Rehabilitation Facility | 811 8th St. Se, Detroit Lakes, MN 56501 | 2015-11-23 |
| 1720344286 | Lakes Crisis & Resource Center | Clinic/Center | 1339 Pelican Lane, Detroit Lakes, MN 56501 | 2012-04-09 |
| 1063657120 | Diane Jean Mccormack | Occupational Therapist | 15840 Long Lake Road, Detroit Lakes, MN 56501 | 2008-12-03 |
| 1588817928 | Darcy Caleb Olson | Counselor | 925 Lake Ave, Detroit Lakes, MN 56501 | 2008-10-29 |
| 1760651079 | Rapidcare Urgent Care Pllc | Family Medicine | 1361 Wenner Road, Detroit Lakes, MN 56501 | 2008-02-21 |
| 1427274729 | Jeffrey C Gregory | Psychologist | 910 Lincoln Ave, Detroit Lakes, MN 56501 | 2007-04-17 |
| 1144364894 | Midwest Vision Centers Inc | Eyewear Supplier (Equipment, not the service) | 830 Washington Avenue, Detroit Lakes, MN 56501 | 2007-02-16 |
| Find all providers in zip 56501 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891965562 | Bruce D Nelson | Eyewear Supplier (Equipment, not the service) | 1131 Jackson Ave, Detroit Lakes, MN 56501-3618 | 2008-03-09 |
| 1144364894 | Midwest Vision Centers Inc | Eyewear Supplier (Equipment, not the service) | 830 Washington Avenue, Detroit Lakes, MN 56501 | 2007-02-16 |
| 1427338722 | Sanford Medical Center Fargo | Eyewear Supplier (Equipment, not the service) | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2011-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1891351268 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1101 E College Dr, Marshall, MN 56258-2366 | 2019-05-11 |
| 1730745100 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1459 W Service Dr, Winona, MN 55987-2512 | 2019-05-11 |
| 1649836016 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1023 E Blue Earth Ave, Fairmont, MN 56031-4076 | 2019-05-11 |
| 1124684592 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1004 18th Ave Nw Ste D, Austin, MN 55912-1993 | 2019-05-11 |
| 1053977421 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1620 Broadway Ave S Ste 4, Rochester, MN 55904-7927 | 2019-05-11 |
| 1942866371 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 4051 W Division St Ste A, Saint Cloud, MN 56301-3741 | 2019-05-10 |
| 1831651165 | Don Sealock, O.d., P.a. | Eyewear Supplier (Equipment, not the service) | 3366 Oakdale Ave N Ste 140, Robbinsdale, MN 55422-2961 | 2019-04-04 |
| 1538624341 | Don Sealock, O.d., P.a. | Eyewear Supplier (Equipment, not the service) | 9825 Hospital Dr # 106, Maple Grove, MN 55369-4479 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
| City | DETROIT LAKES |
| Zip Code | 56501 |
Please comment or provide details below to improve the information on SANFORD CLINIC NORTH.
| 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.