Organization · NPI-2
Sanford Health Of Northern Minnesota
Ophthalmology · Bemidji, MN
NPI number1154587780
StatusActive
Last updated in NPPESJan 23, 2025
Details
- NPI
- 1154587780
- Entity type
- Organization (NPI-2)
- Legal business name
- Sanford Health Of Northern Minnesota
- Organization subpart
- No
- Enumeration date
- Aug 4, 2008
- Certification date
- Jan 23, 2025
- Last updated
- Jan 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | – | – | Yes |
| 152W00000X | Optometrist | – | – | |
| 207N00000X | Dermatology | – | – | |
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – |
Other names
- Sanford Health 1611 Eye Center & Optical (Doing Business As)
Practice location
1611 Anne St NwSte 7
Bemidji, MN 56601-5114
Phone 218-333-2020 · Fax 218-333-2019
Mailing address
Po Box 5074Sioux Falls, SD 57117-5074
Phone 605-328-6585
Other practice locations
1611 Anne St Nw Ste 7
Bemidji, MN 56601-5114
Bemidji, MN 56601-5114
Phone 218-333-2020 · Fax 218-333-2019
Authorized official
Tony Lee Morrison
Vice President, Revenue Cycle
6053288380
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