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General NPI Number Information
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NPI Number | 1760737670
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Entity Type | Organization
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Legal Business Name | SANFORD HEALTH NETWORK NORTH
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 401 12TH ST N
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City | WHEATON
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State | MN
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Zip | 56296-1070
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Country | US
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Telephone | 320-563-8971
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Fax |
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Provider Business Mailing Address
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Address Line | 401 12TH ST N
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City | WHEATON
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State | MN
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Zip | 56296-1070
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Country | US
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Telephone | 320-563-8971
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MARTHA K LECLERC
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Credential |
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Telephone | 701-234-6248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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