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Sanford Health of Northern Minnesota

Organization Active NPI Clinic Pharmacy · Bemidji, MN

NPI 1679677124 · NPPES record last updated Apr 11, 2023

Key facts

NPI
1679677124
Entity type
Organization (NPI type 2)
Primary specialty
Clinic Pharmacy 3336C0002X
License
260530 (MN)
Legal business name
SANFORD HEALTH OF NORTHERN MINNESOTA
Practice address
1233 34TH St NW Ste C
Bemidji, MN 56601
Phone
(218) 333-5265
Fax
(218) 333-5250
NPI assigned
Sep 12, 2006
Organization subpart
No

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
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.

Member of 1

Organizations this organization is a member of, according to 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
O20250521001350 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)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 360230 MN
Clinic Pharmacy 3336C0002X 260530 MN Yes

Addresses

Primary practice location

1233 34TH St NW Ste C
Bemidji, MN 56601

Mailing address

1233 34TH St NW
Bemidji, MN 56601-5112
Phone (218) 333-5265

Other identifiers

IdentifierTypeStateIssuer
1679677124MedicaidMN
2414504OtherNCPDP
82-00337OtherMEDICA

Other names

  • Sanford Pharmacy Bemidji Doing business as

Electronic endpoints

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

Other providers in Bemidji, MN

All providers in Bemidji, MN · Clinic Pharmacy in Minnesota

Sources for this page

Verify at the official NPI Registry.