Healthcare Provider Details

I. General information

NPI: 1285028878
Provider Name (Legal Business Name): SANFORD HEALTH OF NORTHERN MINNESOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 HIGHWAY 71
INTERNATIONAL FALLS MN
56649-2131
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 218-598-5665
  • Fax: 218-598-5329
Mailing address:
  • Phone: 605-328-6585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: TONY LEE MORRISON
Title or Position: VP, CHIEF REVENUE CYCLE OFFICER
Credential:
Phone: 605-328-8380