Organization Name: | SANFORD CLINIC NORTH |
NPI Number: | 1821496290 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARTHA K LECLERC (VICE PRESIDENT) |
Mailing Address: | 111 2nd St Ne Fosston |
State: | MN US |
Postal Code: | 565421301 |
Phone Number: | 2184351010 |
Fax Number: | 2184351715 |
NPI Enumeration Date: | 12/16/2014 |
NPI Last Update Date: | 04/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |