Organization Name: | SANFORD CLINIC NORTH |
NPI Number: | 1083933824 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARTHA K LECLERC (VICE PRESIDENT) |
Mailing Address: | 1611 Anne St Nw Bemidji |
State: | MN US |
Postal Code: | 566015114 |
Phone Number: | 2183332450 |
Fax Number: | 2183332455 |
NPI Enumeration Date: | 05/19/2010 |
NPI Last Update Date: | 07/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336C0002X |
License Number: | 263522 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | Clinic Pharmacy |
Taxonomy Definition: | A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |