Organization Name: | SANFORD CLINIC NORTH |
NPI Number: | 1346256682 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARTHA K LECLERC (VP) |
Mailing Address: | 141 Main Street Ellendale |
State: | ND US |
Postal Code: | 584367101 |
Phone Number: | 7013493331 |
Fax Number: | 7013493212 |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 11/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |