SANFORD CLINIC NORTH (NPI# 1164956645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164956645 |
| Entity Type | Organization |
| Organization Name | SANFORD CLINIC NORTH |
| Practice Address |
1233 34th St Nw Sanford Clinic Pharmacy Bemidji MN 56601-5112 |
| Practice Telephone | 2183335265 |
| Practice Fax Number | 2183335250 |
| Mailing Telephone | 2183335265 |
| Mailing Fax Number | 2183335250 |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2018-05-07 |
| Authorized Official Name | MS. KARLA EISCHENS (DIRECTOR OF PHARMACY OPERATIONS) |
| Authorized Official Telephone | 2183335543 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 115828 | MN | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MN BOARD OF PHARMACY LICENSE | 115828 | 01 |
| 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 |
1233 34TH ST NW SANFORD CLINIC PHARMACY |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-5112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093775900 | David Alan Vanengelenhoven | Emergency Medicine | 1233 34th St Nw, Meritcare Clinic, Bemidji, MN 56601 | 2006-03-24 |
| 1467063297 | Melissa Cook | Social Worker | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2020-08-14 |
| 1669961561 | Sanford Clinic North | Durable Medical Equipment & Medical Supplies | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2018-05-07 |
| 1982055661 | Emmanuel Ortiz Erestain | Internal Medicine | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2016-06-24 |
| 1821407453 | Jennifer Leonhard | Genetic Counselor, MS | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2014-08-07 |
| 1235553140 | Gretchen Lee Bonik | Pharmacist | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2014-02-12 |
| 1023350949 | Terry Joseph Luma | Family Medicine | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2013-03-18 |
| 1841544160 | Brittany Dawn Smith | Dietitian, Registered | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2012-11-08 |
| 1043565757 | Jayasri Alapati | Psychiatry & Neurology | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2012-07-18 |
| 1093095382 | Sanford Medical Center Fargo | Anesthesiology | 1233 34th St Nw, Bemidji, MN 56601-5112 | 2011-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972987675 | Brian Truax | Pharmacist | 602 Beltrami Ave Nw Ste 105, Bemidji, MN 56601-3011 | 2015-07-13 |
| 1093056343 | Gerald Walter Gettel | Pharmacist | 219 Paul Bunyan Dr Nw, Bemidji, MN 56601-2433 | 2013-03-12 |
| 1659658417 | Jeremiah Sellheim | Pharmacist | 2312 Bemidji Ave N, Bemidji, MN 56601-2318 | 2011-11-08 |
| 1467493106 | Gary Lee Olsen | Pharmacist | 1401 Paul Bunyan Dr Nw, Bemidji, MN 56601-4155 | 2006-06-10 |
| 1174595649 | Kent L Redland | Pharmacist | 2785 Ivy Ln Ne, Bemidji, MN 56601-5305 | 2006-02-07 |
| 1962484550 | Paul Scott Iverson | Pharmacist | 408 Minnesota Ave Nw, Bemidji, MN 56601-3127 | 2005-11-18 |
| 1083605489 | Ryan E Okerlund | Pharmacist | 401 Beltrami Ave Nw, Bemidji, MN 56601-3106 | 2005-11-03 |
| 1205435674 | Anna Labitzky | Pharmacist | 2025 Paul Bunyan Dr Nw, Bemidji, MN 56601-5606 | 2020-10-18 |
| 1679182786 | Lindsey Beisner | Pharmacist | 2000 Paul Bunyan Dr Nw, Bemidji, MN 56601-5603 | 2020-07-24 |
| 1700414133 | Vanessa Ryberg | Pharmacist | 408 Minnesota Ave Nw, Bemidji, MN 56601-3127 | 2020-03-31 |
| Find all providers in BEMIDJI | ||||
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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.