NPIMap

Organization Active NPI

Sanford Clinic North

  • Clinic Pharmacy
  • Bemidji, MN
National Provider Identifier
1669961561
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
SANFORD CLINIC NORTH
Practice address
1233 34TH St NW
Bemidji, MN 56601-5112
Phone
(218) 333-5265
NPI assigned
May 7, 2018
Organization subpart
Yes
Parent organization
SANFORD CLINIC NORTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carolyn Tuttle
Title
Vice President, Revenue Cycle
Phone
(605) 328-8384

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

1233 34TH St NW
Bemidji, MN 56601-5112

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other identifiers 1

IdentifierTypeStateIssuer
2414504OtherNCPDP

Other names 1

  • Sanford Pharmacy Bemidji 340B Other name

National Provider Directory

National Provider Directory
Tax ID family
Womens Med Imaging Mobile31 organizations share this tax ID, including this one
Part of
Womens Med Imaging Mobile

Other organizations with this tax ID 30

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

View all 30

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1669961561",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 34TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015112",
            "telephone_number": "218-333-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD CLINIC NORTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANFORD CLINIC NORTH",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "TUTTLE",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "VICE PRESIDENT, REVENUE CYCLE",
        "authorized_official_telephone_number": "605-328-8384"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2414504",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Pharmacy Bemidji 340B",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sanford Pharmacy Bemidji 340B",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.