NPIMap

Sanford Health of Northern Minnesota

Organization Active NPI Pharmacy · Bemidji, MN

NPI 1083933824 · NPPES record last updated Aug 4, 2026

Key facts

NPI
1083933824
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
Legal business name
SANFORD HEALTH OF NORTHERN MINNESOTA
Practice address
1611 Anne St NW Ste 1
Bemidji, MN 56601-5114
Phone
(218) 333-2450
Fax
(218) 333-2455
NPI assigned
May 19, 2010
Organization subpart
No

Authorized official

Name
Tony Lee Morrison
Title
VP, Chief Revenue Cycle Officer
Phone
(605) 328-8380

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 22

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 349

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 349

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in MN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160511000104 MN Part B Supplier - Mass Immunization (Roster Biller Only) 4284546151 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Detroit Lakes, MN; Moorhead, MN; Thief River Falls, MN
O20190917002474 MN Part B Supplier - Mass Immunization (Roster Biller Only) 5597725168 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bemidji, MN; Blackduck, MN
O20250508001098 MN DME Supplier - Pharmacy 5597725168 Practice locations: Bemidji, MN

National Provider Directory

Tax ID family
North Country Health SE (23 organizations share this tax ID)

Locations

1611 Anne St NW
Ste 1
Bemidji, MN 56601
Phone (218) 333-2450

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Yes
Community/Retail Pharmacy 3336C0003X 263522 MN

Addresses

Primary practice location

1611 Anne St NW Ste 1
Bemidji, MN 56601-5114

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other identifiers

IdentifierTypeStateIssuer
2125086OtherPK
2430154OtherNCPDP

Other names

  • Sanford Pharmacy 1611 Anne St Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 4, 2026.

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1083933824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 ANNE ST NW STE 1",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015114",
            "telephone_number": "218-333-2450",
            "fax_number": "218-333-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD HEALTH OF NORTHERN MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VP, CHIEF REVENUE CYCLE OFFICER",
        "authorized_official_telephone_number": "605-328-8380"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "263522",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125086",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2430154",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sanford Pharmacy 1611 Anne St",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bemidji, MN

All providers in Bemidji, MN · Pharmacy in Minnesota

Sources for this page

Verify at the official NPI Registry.