NPIMap

Sanford Health of Northern Minnesota

Organization Active NPI Community/Retail Pharmacy · Blackduck, MN

NPI 1982166765 · NPPES record last updated Jan 23, 2025

Key facts

NPI
1982166765
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
SANFORD HEALTH OF NORTHERN MINNESOTA
Practice address
81 1St St NW
Ste a
Blackduck, MN 56630-0188
Phone
(218) 835-7700
NPI assigned
Apr 2, 2019
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 2

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 (2 enrollments) in MN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190917002474 MN Part B Supplier - Mass Immunization (Roster Biller Only) 5597725168 2 other NPIs on this enrollment
Practice locations: Bemidji, MN; Blackduck, MN
O20250604003633 MN DME Supplier - Pharmacy 5597725168 Practice locations: Blackduck, MN

National Provider Directory

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

81 1St St NW
Ste a
Blackduck, MN 56630-0188

Mailing address

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

Other practice location 1

81 1st St NW Ste A
Blackduck, MN 56630-2228
Phone (218) 835-7700

Other names

  • Sanford Blackduck Pharmacy Doing business as

Electronic endpoints

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

Other providers in Blackduck, MN

All providers in Blackduck, MN · Community/Retail Pharmacy in Minnesota

Sources for this page

Verify at the official NPI Registry.